Decision Support System for Social Needs in ER

Recruiting at 1 trial location

Overseen By Joshua R Vest, PhD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Indiana University

Disqualifiers: Critical illness, Transferred patients, Death, others

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

Compensation: Varies

Number of Visits: Unknown

48000 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new system to help emergency room (ER) staff identify patients who might need social support, such as assistance with housing or food. By providing doctors with information on those who may require extra help, the trial aims to determine if this leads to more screenings and referrals for these services. It will also assess whether this affects the frequency of patients' future healthcare use. Adults visiting certain ERs in Indianapolis who are not critically ill are suitable candidates for this trial. As an unphased trial, this study offers a unique opportunity to contribute to enhancing ER care and support systems.

Do I have to stop taking my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this decision support system is safe for use in emergency departments?

Research shows that the health-related social needs decision support system helps emergency room doctors identify patients who might need extra social support. The system uses risk scores to predict these needs. While not a drug or medical treatment, its safety and impact on patients remain important considerations.

Studies have indicated that decision support systems in healthcare can improve care delivery without causing harm. These systems are generally well-received, as they don't involve physical procedures. They provide information that can help doctors make better decisions. Similar systems have not reported negative effects on patient safety.

This trial aims to determine if the system can increase screening and referral activities and change healthcare usage. As it is not a traditional treatment, there is no risk of physical harm. Instead, it offers a way to potentially improve patient care by addressing social needs that can affect health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the health-related social needs decision support system because it aims to address the social factors affecting health outcomes directly in the emergency room (ER). Unlike traditional ER practices that primarily focus on immediate medical concerns, this system helps identify and provide support for social needs like housing, food, and transportation, which can significantly impact a patient's health. By integrating this decision support system into ER care, the hope is to improve overall health outcomes by tackling these root causes, potentially reducing future ER visits and hospitalizations.

What evidence suggests that this decision support system is effective for managing health-related social needs in the emergency department?

Research has shown that a decision support system can assist emergency department (ED) staff in addressing patients' social needs. In this trial, participants in the decision support intervention group will use the health-related social needs decision support system live. Studies have found that social issues related to health can lead to more ED visits, longer stays, and worse health outcomes. A decision support system uses risk scores to identify patients who might have these needs, helping doctors and nurses screen and refer patients more effectively. Specifically, one study found that using these systems increased the rates of screening and referrals for social needs, improving patient care and health outcomes. ^{3 4 5 6 7}

Who Is on the Research Team?

Joshua R Vest, PhD,MPH

Principal Investigator

Indiana University

Are You a Good Fit for This Trial?

This trial is for emergency department (ED) staff. It's designed to see if using a decision support system, which includes machine learning model results, helps them better screen patients for health-related social needs and potentially reduce repeat ED visits.

Exclusion Criteria

Individuals seeking care in other settings

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

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

Intervention

Introduction of the decision support system with health-related social needs risk scores for all adult patients at one emergency department

Ongoing during emergency department encounters

Follow-up

Participants are monitored for emergency department revisits and primary care visits after the initial encounter

30 days

What Are the Treatments Tested in This Trial?

Interventions

• Health-related social needs decision support system

Trial Overview The intervention being tested is a decision support system that provides reminders to ED providers about patients' social needs based on past data. The study will measure the effectiveness of this tool in increasing screening rates and reducing return visits to the ER.

How Is the Trial Designed?

Group I: Decision support intervention group Experimental Treatment 1 Intervention

Adult ED patients seeking care the ED site with the health-related social needs decision support system live.

Group II: Comparison group Active Control 1 Intervention

Adult ED patients created using statistical matching from ED sites in the same metropolitan area.

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12068607/

Effectiveness of a clinical decision support system with ... This project aims to implement and evaluate a CDS intervention that offers ED clinicians risk prediction scores to determine which patients will likely screen ...

2. bmcemergmed.biomedcentral.com bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-00959-2

Health-related social needs information in the emergency ... Patient health-related social needs (HRSN) complicate care and drive poor outcomes in emergency department (ED) settings.

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39694069/

A Clinical Decision Support System for Addressing Health ... HRSNs are associated with more emergency department (ED) visits, longer stays, and worse health outcomes.

4. vivo.weill.cornell.edu vivo.weill.cornell.edu/display/pubid40354398

Effectiveness of a clinical decision support system ... This project aims to implement and evaluate a CDS intervention that offers ED clinicians risk prediction scores to determine which patients will ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0196064420306557

Screening for Health-Related Social Needs of Emergency ... Among the 166 (86%) responding EDs, 64 (39%) reported screening for at least one health-related social need, 160 (96%) for violence (including intimate partner ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10949703/

Health-related social needs information in the emergency ... Patient health-related social needs (HRSN) complicate care and drive poor outcomes in emergency department (ED) settings.

7. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0323094

Study protocol | PLOS One - Research journals This project aims to implement and evaluate a CDS intervention that offers ED clinicians risk prediction scores to determine which patients will likely screen ...