Health TrialsbyHealthPanel

Adaptation and Pilot Implementation of ePNa Clinical Decision Support for Utah Urgent Care Clinics

ConditionPneumonia
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age12+
SponsorIntermountain Health Care, Inc.

About this trial

We plan to adapt an innovative, validated emergency department (ED) CDS tool based on consensus guidelines for pneumonia care (ePNa) to function in urgent care clinics (Instacares at Intermountain) and combine it seamlessly with Stanford's CheXED artificial intelligence model using an interoperable platform currently under development by Care Transformation Information Services at Intermountain. We will then deploy it to one of two groups of Instacares (randomly selected) using the CFIR framework for Implementation Science best practice.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

All patients ≥ 12 years of age with pneumonia: defined by the J-18.X pneumonia code or acute respiratory failure or sepsis with secondary pneumonia codes

Disqualifiers

Patients without radiographic confirmation of pneumonia

Subsequent episodes of pneumonia within 12 months (so as not to over-represent patients with recurrent pneumonia caused by recurrent aspiration or structural lung disease).

Trial design

Design model

Parallel

Treatments tested in this trial

  • Physician Survey

    Other intervention

    Our questionnaire includes questions on respondent demographics and Likert-style questions about respondent experiences with ePNa. We will validate our modified questionnaire by calculating component loadings and Cronbach Alphas (i.e., internal consistency) of Likert questions loading onto the same components.

  • ePNa-CheXED

    Device

    ePNa-CheXED will incorporate Stanford University's artificial intelligence CheXED model to provide electronic classification of chest images in \<1 second for elements of pneumonia diagnosis and treatment (radiographic pneumonia, single vs multiple lobes, and pleural effusion).

Treatment groups

4,000 Participants
are divided into 2 treatment groups
Group A: Physician SurveyOther 1 intervention
Group B: Adapt ePNa-CheXED for InstaCaresOther 1 intervention

Trial outcomes

Primary outcomes

1

ePNa utilization and impact on the UCC clinical environment

Frequency of clinicians' disagreement with different ePNa recommendations will be monitored along with a tally of the structured reasons for disagreement entered by clinicians into ePNa.

Time frame
through study completion, year 3 of the study

Secondary outcomes

1

Number of unplanned subsequent ED Visits

Time frame
within 7 days of initial encounter
2

Number of unplanned hospitalizations

Time frame
within 7 days of initial encounter
3

Accuracy of pneumonia diagnosis given

defined by compatible chief complaint (cough, dyspnea, chest pain, fever) plus . 1 pneumonia sign/symptom (temperature . 38.0C or \< 36.0C, white blood cell count \>10,000/ul or \<4000/ul), bandemia \>10%, SpO2\<90% on room air, respiratory rate \>20/minute)19 and radiographic confirmation

Time frame
through study completion, year 3 of the study
4

The change in the transfer rate of UCC pneumonia patients to an ED

we want a decrease of . 3% in the ePNa cluster with those transfers replaced by direct hospital admissions or discharge home.

Time frame
through study completion, year 3 of the study

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Intermountain Health Care, Inc.

Lead sponsor

Stanford University

Collaborator

Source ClinicalTrials.gov
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