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

46 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Monthly report card intervention, Storyboard intervention for cardiology care?

Research suggests that providing patients with access to their health information, such as through dashboards, can improve care processes and patient outcomes. This implies that using report cards and storyboards to engage patients in their cardiology care might also lead to better health outcomes. ^{1 2 3 4 5}

How is the Monthly report card and Storyboard intervention treatment different from other treatments for cardiology care?

This treatment is unique because it uses report cards and storyboards to provide patients with clear, visual information about their cardiac care, helping them make informed decisions and potentially improving the quality of care. Unlike traditional treatments that focus solely on medical interventions, this approach emphasizes patient education and engagement. ^{6 7 8 9 10}

What is the purpose of this trial?

This is a prospective randomized clinical trial evaluating how two behaviorally-informed interventions (i.e., monthly report card and storyboard interventions) impact physician behavior, with the goal of closing care gaps in preventive care and disease management. In particular, the monthly report card intervention seeks to elevate physicians' intentions to close their patients' care gaps, while the storyboard intervention seeks to prompt action by making patients' care gaps salient. The trial investigates the separate and joint impacts of the proposed behaviorally-informed interventions on encouraging physicians to close their patients' care gaps.

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

References

1. United States 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. [2022]

2. Canada pubmed.ncbi.nlm.nih.gov

Enriching the Value of Patient Experience Feedback: Web-Based Dashboard Development Using Co-design and Heuristic Evaluation. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Can assessing chronic pain outcomes data improve outcomes? [2019]

4. Germany 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. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Engaging Patients in the Use of Real-Time Electronic Clinical Data to Improve the Safety and Reliability of Their Own Care. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Ethical issues related to cardiac report cards. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Stakeholders' views about cardiac report cards: a qualitative study. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Patients' views about cardiac report cards: a qualitative study. [2008]

9. United States pubmed.ncbi.nlm.nih.gov

Patient care report cards: an analysis. [2019]

10. Australia pubmed.ncbi.nlm.nih.gov

Public disclosure of surgeon-specific report cards: current status of the debate. [2016]