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Completed

NCT Number: NCT06655974

Predictive Modeling for Social Needs in Emergency Department Settings

The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:

* Does providing emergency department clinicians with risk scores on health-related social needs increase screening and referral activities? * Does providing emergency department clinicians with risk scores on health-related social needs change patients' use of healthcare services?

The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.

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Key information

Conditions

Emergency Service, Hospital Disease Attributes Emergencies Pathologic Processes Pathological Conditions, Signs and Symptoms Social Determinants of Health

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Indiana University Health

Indianapolis, Indiana, 46202, United States

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Adults (>18 years old)
  • Seeking care at Indianapolis, Indiana area emergency departments (EDs).

Exclusion criteria

  • Children
  • Encounters by patients that present with a critical illness/injury (e.g. severe trauma patients or those with Emergency Severity Index (ESI) classification level 1)
  • Encounters by patients who have been transferred from another inpatient facility
  • Patients that die during the ED encounter
  • Encounters among patients who were ultimately admitted during their ED visits from our analysis

Treatment and study plan

Health-related social needs decision support system

Other

The clinical decision support intervention will present emergency department clinicians at an Indianapolis, IN ED with a likelihood score for an adult patient screening positive for the following health-related social needs (HRSNs): housing instability, food insecurity, transportation barriers, financial strain, and history of legal involvement. For each HRSN, the likelihood of screening positive is reported as "high", "medium", or "low". These categorizations are the product of logistic regression models. The clinical decision support intervention will be delivered through an existing FHIR (Fast Healthcare Interoperability Resources) standards-based clinical decision support platform.

Primary outcomes

  1. Percent of emergency department encounters screened for health-related social needs (HRSNs)

    Time frame: At time of emergency department encounter (or within 24 hours)

    The numerator will be an emergency department encounter with any indication of HRSN screening using any tool or questionnaire, regardless of patient completion or results. The denominator will be all eligible ED encounters.

  2. Percent of emergency department encounters that were referred for health-related social needs (HRSNs) services

    Time frame: At time of emergency department encounter (or within 24 hours)

    The numerator will be emergency department encounters with a referral to social worker, case management, community health workers, or related services within 24 hours of the ED encounter. The denominator will be all eligible ED encounters

Secondary outcomes

  1. Percent of encounters with an emergency department revisit measured at 3 days

    Time frame: within 3 days of emergency department encounter

    The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 3 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.

  2. Percent of encounters with an emergency department revisit measured at 7 days

    Time frame: within 7 days of emergency department encounter

    The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 7 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.

  3. Percent of encounters with an emergency department revisit measured at 30 days

    Time frame: within 30 days of emergency department encounter

    The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 30 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator

  4. Percent of emergency department encounters with primary care visit within 7 days of an ED encounter

    Time frame: within 7 days of emergency department visit

    The numerator will include all emergency department encounters with a completed family medicine, internal medicine, OBGYN, or geriatrician visit64 within 7 days of the ED visit. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.

Other outcomes

  1. Percent of emergency department encounters where the health-related social needs (HRSN) decision support system intervention was accessed.

    Time frame: At time of emergency department encounter (or within 24 hours)

    The numerator will include encounters with access of the social needs section (containing the risk prediction scores) of the decision support system intervention during the study visit (defined as within 24 hours). Access will be defined as record of the end user visiting the HRSN page in the system user logs. The denominator will be all eligible ED encounters. Limited to the intervention site only.

  2. Percent of emergency department encounters where the clinical decision support platform was accessed

    Time frame: At time of emergency department encounter(or within 24 hours)

    The numerator will include encounters with access of clinical decision support platform during the study visit (defined as within 24 hours). Access will be defined as record of the end user visiting initiating a request to the decision support application from the EHR. Any portion of the decision support platform (not just the health-related social needs section) is included. The denominator will be all eligible ED encounters (see Inclusion criteria, above). Limited to the intervention site only

Sponsors and collaborators

Lead sponsor

Indiana University

Other

Registry information

Official study title

Protocol for Evaluating the Effectiveness of a Clinical Decision Support System With Prediction Modeling to Identify Patients With Health-related Social Needs in the Emergency Department

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Oct 24, 2024
Registry last updated
Mar 31, 2026

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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