Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention.

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.

A chart demonstrating what to do in response to several common conditions where the patient might be compelled to visit the ED

Visited the ED inappropriately (y/n) We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate.

Inclusion Criteria: Age 18+ Has a Geisinger Primary Care Physician assigned Completes an outpatient office visit or telemedicine appointment at Geisinger Exclusion Criteria: The AVS was not printed according to the EHR, and the patient does not have an active MyGeisinger patient portal account, so they do not have a way to view the AVS

Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.

By the paper's online publication date. Data will remain available for as long as the Open Science Framework hosts it.