Report Cards + Storyboards for Cardiology Care

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Trial designers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests new methods to help doctors enhance heart care. The goal is to determine if monthly report cards or storyboards (visual reminders) help doctors close care gaps for their patients. The researchers aim to discover if these tools encourage doctors to take action and manage heart disease more effectively. Cardiologists at UCLA Health clinics with over 50 patients may be eligible to participate. As an unphased trial, this study provides a unique opportunity for patients to contribute to innovative approaches in heart care management.

Do I need to stop my current medications for this trial?

The trial does not specify whether participants need to stop taking their current medications.

What prior data suggests that these behaviorally-informed interventions are safe for physician use?

Research shows that using report cards and storyboards in healthcare is generally safe. These tools aim to enhance doctors' performance rather than directly treat patients, so specific data on side effects is unavailable.

The monthly report card helps doctors improve care by highlighting areas for improvement. It provides feedback on their performance, enabling them to enhance care without directly impacting patients' health.

The storyboard clarifies patient care needs for doctors, aiding in the recall of important steps. Research on similar tools suggests it can reduce mistakes by simplifying information.

Both tools focus on helping doctors manage patient care better, not on treating medical conditions directly. Since they target behavior, no known risks or side effects exist, unlike those associated with new drugs or medical devices. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the "Report Cards + Storyboards for Cardiology Care" trial because it explores innovative ways to improve physician performance and patient outcomes. Unlike traditional methods that rely on quarterly feedback, this trial tests monthly report cards and EHR-integrated storyboards to keep doctors informed and motivated to close care gaps. The monthly report cards provide regular, behaviorally-informed updates to encourage better patient care, while the storyboard intervention offers real-time, visible reminders of patient needs during consultations. These interventions have the potential to enhance the effectiveness of cardiology care by fostering timely and actionable insights for physicians.

What evidence suggests that these interventions are effective for improving cardiology care?

In this trial, some physicians will receive a monthly report card intervention. Research has shown that this can improve heart care for patients. In one study involving 56,000 patients, personalized monthly report cards and alerts in electronic health records (EHRs) led to better heart care in clinics.

Other physicians will receive a storyboard intervention, which highlights care gaps directly in EHRs. Studies have shown that using storyboards improves patient care and outcomes by helping doctors adhere more closely to recommended screenings and treatments. Both methods simplify the process for doctors to identify and address care gaps, potentially leading to better patient health. ^{5 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for cardiologists at UCLA Health who see patients outside the hospital, are part of a cardiology bonus program, and have more than 50 patients. Cardiologists who helped design this study can't join.

Inclusion Criteria

Enrolled in the pre-existing cardiology financial incentive program at UCLA Health

With patient panel size above 50

Cardiologists who practice at one or more UCLA Health sites in the outpatient setting

Exclusion Criteria

Cardiologists who were involved in the design of the trial

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Physicians receive behaviorally-informed interventions to close care gaps, including monthly report cards and enhanced EHR visibility.

12 months

Follow-up

Participants are monitored for care gap closure and effectiveness of interventions.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Monthly report card intervention
• Storyboard intervention

Trial Overview The study tests two ideas to improve heart doctors' care: one gives them a monthly 'report card' on their work, and the other uses patient stories to highlight what needs attention. It looks at how each method or both together might make doctors better at preventive care and managing diseases.

How Is the Trial Designed?

Group I: Arm 4: Monthly report card AND Storyboard Experimental Treatment 2 Interventions

Eligible, randomly assigned physicians will receive behaviorally-informed monthly emails and get a more visible care gap banner in the electronic health record (EHR) upon patient encounter.

Group II: Arm 3: Storyboard only Experimental Treatment 1 Intervention

Eligible, randomly assigned physicians will receive status quo quarterly emails and get a more visible care gap banner in the electronic health record (EHR), intended to promptly remind them of each patient's care gaps at the start of a patient-physician encounter.

Group III: Arm 2: Monthly report card only Experimental Treatment 1 Intervention

Eligible, randomly assigned physicians will receive behaviorally-informed monthly emails (monthly performance report card) intended to elevate their intentions to improve their performance (i.e., getting more of their patients to close care gaps).

Group IV: Arm 1: Quarterly performance email (current state, control condition) Active Control 1 Intervention

Eligible, randomly assigned physicians will receive status quo quarterly emails with their performance report card.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

UCLA Health Department of Medicine

Collaborator

Trials

4

Recruited

82,000+

Published Research Related to This Trial

The Pediatric Quality of Life Inventory (PedsQL) showed strong responsiveness and predictive validity in a study of 4,637 pediatric patients, indicating it can effectively measure changes in health-related quality of life during hospital stays.

Patients with medically complex conditions had lower improvement scores on the PedsQL compared to those without chronic conditions, and lower admission scores were linked to higher risks of prolonged hospital stays and readmissions, highlighting its potential as a tool for assessing patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validity and responsiveness of the pediatric quality of life inventory (PedsQL) 4.0 generic core scales in the pediatric inpatient setting. Desai, AD., Zhou, C., Stanford, S., et al.[2022]

Integrating patient-reported outcomes data into the management of chronic, non-cancer pain can significantly guide improvements in patient care and outcomes.

Standardizing care processes and using valid outcome measurement tools can enhance the effectiveness of treatment while minimizing the burden on patients and healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can assessing chronic pain outcomes data improve outcomes? Witkin, LR., Farrar, JT., Ashburn, MA.[2019]

Patient-reported outcome measure (PROM) feedback interventions in oncology showed a positive impact on health-related quality of life (HRQL) and patient-healthcare provider communication, with a moderate effect size based on a meta-analysis of 29 studies involving 7071 cancer patients.

The intervention also demonstrated a significant improvement in 1-year overall survival rates, suggesting that providing feedback can enhance care processes and outcomes for cancer patients, although the findings are limited by a high risk of bias in the studies reviewed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of routine provision of feedback from patient-reported outcome measurements for cancer care improvement: a systematic review and meta-analysis. Lu, SC., Porter, I., Valderas, JM., et al.[2023]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06277323

NCT06277323 | UCLA Health Patient Cardiology Care Gaps This is a prospective randomized clinical trial evaluating how two behaviorally-informed interventions (i.e., monthly report card and storyboard ...

2. withpower.com withpower.com/trial/phase-health-maintenance-2024-74504

Report Cards + Storyboards for Cardiology Care Physicians receive behaviorally-informed interventions to close care gaps, including monthly report cards and enhanced EHR visibility. ... Participants are ...

3. jacc.org jacc.org/doi/10.1016/S0735-1097%2825%2903022-0

A RANDOMIZED CONTROLLED TRIAL OF 56000 PATIENTS Methods. We developed a personalized monthly report card and electronic health record (EHR) banner to improve outpatient cardiology care gap ...

4. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2829187

Electronic Patient-Reported Outcome System ... This randomized clinical trial evaluates changes in patient satisfaction, quality of information provided by physicians, and patient disease ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5855256/

Effectiveness of implementation interventions in improving ... The primary outcomes included the proportion of eligible patients with HF who: were prescribed a guideline-recommended pharmacological treatment ...

6. ahajournals.org ahajournals.org/doi/10.1161/CIR.0000000000001243

2024 Update of the Utstein Out-of-Hospital Cardiac Arrest ... Supplementary outcomes were rarely used in citing studies: transported to hospital (2.2%), cause of death (1.3%), treatment withdrawn (1.3%), ...

7. jacc.org jacc.org/doi/10.1016/j.jacc.2015.11.001

The National Cardiovascular Data Registry Voluntary ... This hospital-level voluntary effort will initially report process of care measures from the percutaneous coronary intervention (CathPCI) and ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6093852/

Public Reporting of Percutaneous Coronary Intervention ... Despite evidence that public reporting of PCI outcomes has not clearly improved care quality or empowered patients, reporting efforts are proliferating ...

9. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK597669/

Use of Report Cards and Outcome Measurements To Improve ... Report cards have emerged as a method of measuring and reporting surgical outcomes, and they serve as a stimulus for quality improvement and increased ...