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NCT Number: NCT05167227

Does a Technology Enabled Multi-disciplinary Team-based Care Model for the Management of Long COVID and Other Fatiguing Illnesses Improve Clinical Care of Patients and Represent a Sustainable Approach Within a Federally Qualified Health Center?

The primary objective of the present research is to determine the effectiveness of Family Health Center of San Diego's Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) on clinician- and patient-level outcomes. LC&FIRP is comprised of a teleECHO program focused on multi-specialty case-consultation and peer-to-peer sharing of emerging best practices to support management of complex cases associated with Long COVID, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI). Our secondary objective is to determine the feasibility, acceptability, and sustainability of LC&FIRP. Our findings should provide a fuller understanding of the potential impact of innovative technology enabled multi-disciplinary team-based care models in low-resource, community-based primary care settings.

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Key information

Conditions

SARS-CoV-2 Acute Respiratory Disease COVID-19 Chronic Disease Chronic Fatigue Syndrome Coronaviridae Infections Coronavirus Infections Disease Attributes Encephalomyelitis Fatigue Syndrome, Chronic Infections Lung Diseases Muscular Diseases Musculoskeletal Diseases Myalgic Encephalomyelitis Nervous System Diseases Neuroinflammatory Diseases Neuromuscular Diseases Nidovirales Infections Pathologic Processes Pathological Conditions, Signs and Symptoms Pneumonia Pneumonia, Viral Post COVID-19 Condition Post-Acute COVID-19 Syndrome Post-Acute Sequelae of SARS-CoV-2 Infection Post-Infectious Disorders RNA Virus Infections Respiratory Tract Diseases Respiratory Tract Infections Virus Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Family Health Centers of San Diego

San Diego, California, 92102, United States

About this study

The primary objective of the present research is to determine the effectiveness of FHCSD's Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) on clinician- and patient-level outcomes. LC&FIRP is comprised of a teleECHO program focused on multi-specialty case-consultation and peer-to-peer sharing of emerging best practices to support management of complex cases associated with Long COVID, ME/CFS, and other PIFI. Our secondary objective is to determine the feasibility, acceptability, and sustainability of LC&FIRP. Our findings should provide a fuller understanding of the potential impact of innovative technology enabled multi-disciplinary team-based care models in low-resource, community-based primary care settings. This study will provide much needed high-quality evidence on the effectiveness of a technology enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a community clinic setting, while simultaneously providing evidence regarding the feasibility, acceptability, and sustainability of the approach. Given that LC&FIRP includes a teleECHO program that is case-based, interactive, and occurs in real-time, it has a set of distinct advantages to the traditional practice of sequential in-person specialty referrals to address complex patient cases. The investigators hypothesize that clinician exposure to weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to clinician exposure to monthly interactive webinars and quarterly short courses alone.

The investigators will evaluate LC&FIRP using an effectiveness-implementation hybrid type 2 design. Specifically, the investigators will conduct a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial. The target for weekly teleECHO sessions, monthly interactive webinars, and quarterly short courses are licensed health care professionals. Therefore, the present research will include professional clusters that will consist of primary care physicians, physician assistants, and nurse practitioners at FHCSD caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with Long COVID, ME/CFS, and/or other PIFI.

20 consenting clinicians across primary care clinics at FHCSD will be randomized at a ratio of 1:1 to either participate in 1) weekly teleECHO sessions with monthly interactive webinars and quarterly short courses or 2) monthly interactive webinars and quarterly short courses alone (a control group). All clinicians will have the option to receive continuing medical education credit for the educational sessions they engage in. Throughout participation, the investigators expect that the clinicians will provide care for approximately 856 FHCSD patients diagnosed with Long COVID, ME/CFS, or other PIFI (approximately 42 patients per clinician). The clinicians will be consented and will receive exposure to intervention components (i.e., a professional cluster). Therefore, patient outcomes derived from routine clinical care will be evaluated according to the study arm of their respective clinicians. Outcomes will be measured at 3-, 6-, 9-,12-, 18-, 24-, and 30-months post-baseline for clinicians and for patients at 3-, 6-, 9-, and 12-months post assignment to a participating clinician.

Inclusion criteria

for clinicians includes 1) being employed by FHCSD for clinical care delivery, 2) being a licensed primary care physician, physician assistant, or nurse practitioner, 3) caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with Long COVID, ME/CFS, and/or other PIFI, and 4) being willing and able to actively participate in LC&FIRP. There are no exclusion criteria. FHCSD medical leadership has verbally extended an invitation to the approximately 200 eligible clinicians at FHCSD to participate in LC&FIRP (a follow-up email will also be sent). Those who are interested will provide written informed consent, complete a baseline survey, and will be randomized to one of the two study arms. An electronic randomization list will be generated using the latest version of the statistical software platform R (version 3.3.2, http://www.r-project.org). The list will be securely integrated into the cloud-based Research Electronic Data Capture (REDCap) tool. Allocation will be concealed from all investigators and staff until the study group is assigned. Only the study manager and research assistants involved in the delivery of the intervention components will subsequently be made aware of allocation. It is not possible to mask participating clinicians, however, patients of participating clinicians will not have knowledge of their clinicians potential participation in weekly teleECHO sessions, monthly interactive webinars, and quarterly short courses. All staff that are involved in the collection of data and investigators that conduct analyses will remain blinded to allocation throughout the study.

Clinician participation in this study is voluntary. Participating clinicians may decide not to participate or may leave the study at any time. This decision will not result in any penalty or loss of benefits to which they are entitled. Information that has already been collected may still be used, but no new information will be collected. The withdrawal reason and the withdrawal date will be documented.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Inclusion criteria for clinicians includes 1) being employed by FHCSD for clinical care delivery, 2) being a licensed primary care physician, physician assistant, or nurse practitioner, 3) caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with PASC, ME/CFS, and/or OPIFI, and 4) being willing and able to actively participate in LC&FIRP.

Exclusion criteria

  • There are no exclusion criteria.

Treatment and study plan

Extension for Community Healthcare Outcomes

Other

ECHO is a technology enabled multi-disciplinary team-based care model centered on case-consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO) to support management of complex cases associated with Long COVID, ME/CFS, and other PIFI.

Other names: ECHO

Primary outcomes

  1. Patient-Reported Outcomes Measurement Information System (PROMIS)-29

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

Secondary outcomes

  1. Patient symptom checklist with associated severity for those present

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, None, Mild, Moderate, Severe

  2. If symptom is present, has patient experienced this in the past month

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes/No

  3. If symptom is present, how long has patient experienced this symptom

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Under 3 Months, 3 Months or longer

  4. If symptom is present, did patient have this symptom before the patient tested positive for COVID-19?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes/No

  5. If symptom is present, during the past month how often have the patient had this symptom?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys with use of Likert scale

  6. If symptom is present during the past month, how bad was this symptom?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys with use of Likert scale

  7. For symptoms present, do any of them get worse for at least 24 hours after engaging in activities (physical or mental) that patient was used to doing with no problems?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys with Yes/No/Not Applicable/Don't Know

  8. If fatigue, tiredness, or exhaustion is present, doesn't patient describe it as feeling it come on all of a sudden, or slowly over time

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys with All of sudden, Slowly over time, Not applicable, Don't know

  9. If fatigue present, what month and year did the fatiguing illness begin?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, estimated month and year

  10. When fatigued, does rest make patient's fatigue better?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes a lot, Yes a little, No not very much, Not applicable, Don't know

  11. When fatigued, has this fatigue substantially limited the patient's ability to occupational, educational, social, or personal activities?

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes, No, Not applicable, Don't know

  12. Patient's medical history check-list

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes, No, Unsure

  13. Patient's dietary restrictions

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, No, Vegan, Vegetarian, Ketogenic, Gluten-free, Dairy-free, Intermittent fasting, Other

  14. Patient's food allergies or other food intolerances

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes/No

  15. Has patient's employment been impacted due to contracting COVID-19?

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes, No

  16. Patient's frequency to complete 150-minutes per week of moderate-intensity physical activity (like a brisk walk, slow biking, gardening, or ballroom dancing) prior to contracting COVID-19

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Every week, Most weeks, Some weeks, Very few weeks, Never, I do not know

  17. Patient's frequency to complete 150-minutes per week of vigorous-intensity physical activity (like running, swimming laps, competitive sports, or fast bicycling) prior to contracting COVID-19

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Every week, Most weeks, Some weeks, Very few weeks, Never, I do not know

  18. Did patient receive a COVID-19 PCR (nasal swab) test

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes/No

  19. Did patient receive a COVID-19 antibody test

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes/No

  20. Patient symptom onset

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Date

  21. Patient reported medications used for COVID-19 symptoms

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, free text

  22. Patient reported prescribed supplementary oxygen support

    Time frame: Through study referral period, an average of 12 weeks

    Patient baseline survey, Yes/No

  23. Patient reported admittance to hospital due to COVID-19

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes/No

  24. Do any of the following activities exacerbate patients symptoms: Physical exertion, Diet Changes, Big Meal, Dehydration, Weather changes (hot and humid), Tight clothing, Stress or anxiety, Pre Menstrual period, Menstrual period, Alcohol consumption

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys, Yes/No

  25. Does patient feel fully recovered from COVID-19

    Time frame: During 9 months of follow-up

    Patient quarterly surveys, Yes/No

  26. Currently minutes per week of moderate-intensity physical activity patient does (like a brisk walk, slow biking, gardening, or ballroom dancing)

    Time frame: During 9 months of follow-up

    Patient quarterly surveys, free text

  27. Currently minutes per week of vigorous-intensity physical activity patient does (like running, swimming laps, competitive sports, or fast bicycling)

    Time frame: During 9 months of follow-up

    Patient quarterly surveys, free text

  28. Patient Health Questionnaire (PHQ)-2

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

  29. Patient Health Questionnaire (PHQ)-9 (if applicable)

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

  30. PROMIS Dyspnea Functional Limitations and Severity Short Forms

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

  31. PROMIS Applied Cognition Abilities and General Concerns Short Forms

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

  32. Generalized Anxiety Disorder (GAD)-7

    Time frame: During 12 months of follow-up

    Patient baseline and quarterly surveys

  33. 2-minute step test

    Time frame: During 12 months of follow-up

    Physical Therapy assessment with patient

  34. 30 sec sit to stand test

    Time frame: During 12 months of follow-up

    Physical Therapy assessment with patient

  35. Grip strength

    Time frame: During 12 months of follow-up

    Physical Therapy assessment with patient

  36. Functional Gait Assessment

    Time frame: During 12 months of follow-up

    Physical Therapy assessment with patient

  37. Balance tasks

    Time frame: During 12 months of follow-up

    Physical Therapy assessment with patient

  38. Post-exertional malaise follow-up

    Time frame: Per Physical Therapy encounter after PT assessment

    Follow-up Physical Therapy appointment with patient, Not at all, A little bit, Somewhat, Quite a bit, Very much

Other outcomes

  1. Knowledge improvement of appropriate PASC diagnosis as a result of participation in randomized arm (teleECHO or monthly webinar)

    Time frame: During 37 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  2. Knowledge improvement of effective PASC care and treatment as a result of participation in randomized arm (teleECHO or monthly webinar)

    Time frame: During 37 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  3. Knowledge improvement of approaches for complex cases of PASC as a result of participation in randomized arm (teleECHO or monthly webinar)

    Time frame: During 37 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  4. Self-efficacy in abilities related to identify tools and methods for PASC care

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  5. Self-efficacy in abilities to diagnose patients with PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  6. Self-efficacy in abilities to screen for co-morbidities of PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  7. Self-efficacy in abilities to generate a patient-specific treatment plan for patients with PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  8. Self-efficacy in abilities related to to implement a patient-specific treatment plan for patients with PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  9. Self-efficacy in abilities to select appropriate special or diagnostic tests for PASC patients

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  10. Self-efficacy in abilities to interpret special or diagnostic test results for my PASC patients

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  11. Self-efficacy in abilities to provide appropriate patient education about their PASC condition

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  12. Self-efficacy in abilities to educate clinic staff about PASC care

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  13. Self-efficacy in abilities to address PASC patients using a multidisciplinary approach

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  14. Self-efficacy in abilities to assess and manage concerns that PASC patients face

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  15. Self-efficacy in abilities to assess severity of disease in patients with PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  16. Self-efficacy in abilities to deal with complex cases of PASC

    Time frame: During 37 months of follow-up

    Clinician baseline and quarterly follow-up survey with use of Likert scale agreement

  17. Utility of an encountered case presented during randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey Yes/No

  18. Overall satisfaction with randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  19. Satisfaction to recommend to colleague randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale likelihood

  20. Satisfaction to participate in future randomized arm (teleECHO or monthly webinar) again

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale likelihood

  21. Changes to practice in helping colleague with information learned from randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey Yes/No

  22. Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to understand further monitoring and follow-up plan

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  23. Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to develop more appropriate treatment plans

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  24. Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to have a better understanding of underlying disease process and the role of specialist referral

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  25. Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to more independently manage my PASC patients without referral to a specialist

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement

  26. Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to apply specialist recommendations to patient care.

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement and free text

  27. Unable to apply learnings from randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with use of Likert scale agreement and free text

  28. Other changes to practice by participating in randomized arm (teleECHO or monthly webinar)

    Time frame: During 34 months of follow-up

    Clinician quarterly follow-up survey with free text

  29. Knowledge gained about topic presented during teleECHO before and after

    Time frame: During 37 months after each weekly ECHO session

    Clinician intervention teleECHO survey

  30. Knowledge gained about topic presented during teleECHO before and after

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale knowledge

  31. Satisfaction with stated objectives being met

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  32. Satisfaction with session delivering balanced and objective, evidence-based content

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  33. Satisfaction with pace of session

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  34. Satisfaction with opportunities to ask questions

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  35. Satisfaction with organization of the presenters' presentations

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  36. Satisfaction with presenters' ability to clearly communicate

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale quality

  37. Desired content for future sessions

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey, free text

  38. Satisfaction with source evidence presented

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey Yes/No

  39. Satisfaction with commercial bias present

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey Yes/No and free text

  40. Recommendations for program improvement

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey free text

  41. Relevance of session to clinicians current work

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale relevance

  42. Intent to change practice based on learnings from session

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey Yes/No and free text

  43. Best part of session

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey free text

  44. Worst part of session

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey free text

  45. Recommend this session to a colleague

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey with use of Likert scale likelihood

  46. Changes to practice planned

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey free text

  47. If no changes to practice are planned, barriers

    Time frame: Through study completion, an average of 37 months

    Clinician intervention teleECHO survey free text

  48. Participating clinician retention

    Time frame: Semi-annually during 37 months of follow-up

    Mean number of months clinicians participate in the trial (intervention and control groups)

  49. Participating clinic settings

    Time frame: Semi-annually during 37 months of follow-up

    Number of clinic settings in which providers see patients (intervention and control groups)

  50. Participation in intervention

    Time frame: Weekly during 37 months of follow-up

    Number of weekly sessions each RCT (intervention) provider attends, and mean number

  51. Exposure of weekly teleECHO topics

    Time frame: Weekly during 37 months of follow-up

    Number of topics covered in Weekly ECHO sessions RCT (intervention) provider attends

  52. Monthly webinar attendance

    Time frame: Monthly during 37 months of follow-up

    Number of monthly webinars RCT providers attends

  53. Quarterly short course attendance

    Time frame: Quarterly during 37 months of follow-up

    Number of quarterly short courses RCT providers attends

  54. Exposure of monthly webinar topics

    Time frame: Monthly during 37 months of follow-up

    Number of topics covered in monthly webinars provider attends

  55. Exposure of quarterly short course topics

    Time frame: Quarterly during 37 months of follow-up

    Number of topics covered in quarterly short courses provider attends

  56. Participation in case consultation

    Time frame: Quarterly during 37 months of follow-up

    Number of patient cases presented by RCT (intervention) provider

  57. Participation in post-session survey

    Time frame: Weekly during 37 months of follow-up

    Proportion of participants that complete each session poll (disaggregated by monthly webinar, weekly session, RCT vs. non-RCT provider)

  58. Volume of total patient case load

    Time frame: Monthly during 37 months of follow-up

    Number of patients seen by RCT provider, and mean number (intervention and control)

  59. Volume of PASC patient case load

    Time frame: Monthly during 37 months of follow-up

    Number of PASC patients seen by RCT provider, and mean number (intervention and control)

  60. Volume of patient referrals to specialists

    Time frame: Monthly during 37 months of follow-up

    Number of referrals to specialists by RCT provider, and mean number (intervention and control)

  61. Application of specialist recommendations

    Time frame: Quarterly during 37 months of follow-up

    Number of specialist recommendations applied by RCT (intervention) providers from weekly ECHO sessions

  62. Average consultation duration

    Time frame: Monthly during 37 months of follow-up

    Mean duration of consultation for PASC patients by RCT providers, intervention and control

  63. Volume of specialists seen by patients

    Time frame: Monthly during 37 months of follow-up

    Number of specialists seen by patient

  64. Specialty types patient was exposed to

    Time frame: Monthly during 37 months of follow-up

    Number of specialty types the patient was exposed to

  65. Clinician session drop-off

    Time frame: Weekly during 37 months of follow-up

    How long an (intervention) provider attended an ECHO session

  66. Quarterly attendance

    Time frame: Quarterly during 37 months of follow-up

    Number of individuals who attended and watched short course

  67. Clinician satisfaction with series

    Time frame: Up to 8 weeks after end of study

    Interview with Likert satisfaction

  68. Clinician overall best part of series

    Time frame: Up to 8 weeks after end of study

    Interview

  69. Clinician overall worst part of series

    Time frame: Up to 8 weeks after end of study

    Interview

  70. Clinician challenges in participating

    Time frame: Up to 8 weeks after end of study

    Interview

  71. Perceived change in the relationship between clinicians and specialists in panel as a result of this series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  72. Clinician barriers to sustained participation in series

    Time frame: Up to 8 weeks after end of study

    Interview

  73. Did clinician experience an improvement in the number of PASC patients they could manage at any given time as a result of the series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  74. Did clinicians experience an increase in PASC patients in their panel composition over time as a result of participation in the series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  75. Did clinic directors observe an increase in PASC patients in the clinicians panel composition over time as a result of their participation in the series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  76. Did clinicians experience an improvement in the quality of care for patients as a result of participating in the series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  77. Did clinic directors observe an improvement in the quality of care for patients as a result of a clinician participating in the series?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  78. Did clinicians participating influence other providers in their clinic?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  79. Did clinic directors observe clinicians who participated in the series influence other providers within the clinic?

    Time frame: Up to 8 weeks after end of study

    Interview, Yes/No with free response

  80. Clinician benefits gained from participating in the series

    Time frame: Up to 8 weeks after end of study

    Interview, free response

  81. Clinician recommendations for improving the scalability or sustainability of this model

    Time frame: Up to 8 weeks after end of study

    Interview, free response

  82. Clinic directors recommendations for improving the scalability or sustainability of this model

    Time frame: Up to 8 weeks after end of study

    Interview, free response

Sponsors and collaborators

Lead sponsor

Family Health Centers of San Diego

Other

Registry information

Official study title

The Long COVID and Fatiguing Illness Recovery Program - A Pragmatic, Quality Improvement, Professional Cluster, Randomized Controlled Trial.

Acronym: LC&FIRP

Important dates

Study start
2021
Primary completion
2024
Study completion
2025
First posted
Dec 22, 2021
Registry last updated
Aug 6, 2025

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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