scholarly journals Electronic medical record–based cohort selection and direct-to-patient, targeted recruitment: early efficacy and lessons learned

2019 ◽  
Vol 26 (11) ◽  
pp. 1209-1217 ◽  
Author(s):  
Hailey N Miller ◽  
Kelly T Gleason ◽  
Stephen P Juraschek ◽  
Timothy B Plante ◽  
Cassie Lewis-Land ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Response Rate ◽  
Target Population ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Eligibility Criteria ◽  
Health Network ◽  
Recruitment Methods ◽  
Cohort Selection

Abstract Objective The study sought to characterize institution-wide participation in secure messaging (SM) at a large academic health network, describe our experience with electronic medical record (EMR)–based cohort selection, and discuss the potential roles of SM for research recruitment. Materials and Methods Study teams defined eligibility criteria to create a computable phenotype, structured EMR data, to identify and recruit participants. Patients with SM accounts matching this phenotype received recruitment messages. We compared demographic characteristics across SM users and the overall health system. We also tabulated SM activation and use, characteristics of individual studies, and efficacy of the recruitment methods. Results Of the 1 308 820 patients in the health network, 40% had active SM accounts. SM users had a greater proportion of white and non-Hispanic patients than nonactive SM users id. Among the studies included (n = 13), 77% recruited participants with a specific disease or condition. All studies used demographic criteria for their phenotype, while 46% (n = 6) used demographic, disease, and healthcare utilization criteria. The average SM response rate was 2.9%, with higher rates among condition-specific (3.4%) vs general health (1.4%) studies. Those studies with a more inclusive comprehensive phenotype had a higher response rate. Discussion Target population and EMR queries (computable phenotypes) affect recruitment efficacy and should be considered when designing an EMR-based recruitment strategy. Conclusions SM guided by EMR-based cohort selection is a promising approach to identify and enroll research participants. Efforts to increase the number of active SM users and response rate should be implemented to enhance the effectiveness of this recruitment strategy.

scholarly journals Use of electronic recruitment methods in a clinical trial of adults with gout

2020 ◽  
pp. 174077452095696
Author(s):  
Hailey N Miller ◽  
Jeanne Charleston ◽  
Beiwen Wu ◽  
Kelly Gleason ◽  
Karen White ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Response Rate ◽  
Cost Effective ◽  
Demographic Characteristics ◽  
Completion Rate ◽  
Patient Portal ◽  
Recruitment Methods

Background/aims: Electronic-based recruitment methods are increasingly utilized in clinical trials to recruit and enroll research participants. The cost-effectiveness of electronic-based methods and impact on sample generalizability is unknown. We compared recruitment yields, cost-effectiveness, and demographic characteristics across several electronic and traditional recruitment methods. Methods: We analyzed data from the diet gout trial recruitment campaign. The diet gout trial was a randomized, controlled, cross-over trial that examined the effects of a dietary approaches to stop hypertension (DASH)–like diet on uric acid levels in adults with gout. We used four electronic medical record and four non-electronic medical record–based recruitment methods to identify and recruit potentially eligible participants. We calculated the response rate, screening visit completion rate, and randomization rate for each method. We also determined cost per response, the screening, and randomization for each method. Finally, we compared the demographic characteristics among individuals who completed the screening visit by recruitment method. Results: Of the 294 adults who responded to the recruitment campaign, 51% were identified from electronic medical record–based methods. Patient portal messaging, an electronic medical record–based method, resulted in the highest response rate (4%), screening visit completion rate (37%), and randomization rate (21%) among these eight methods. Electronic medical record–based methods ($60) were more cost-effective per response than non-electronic medical record–based methods ($107). Electronic-based methods, including patient portal messaging and Facebook, had the highest proportion of White individuals screened (52% and 60%). Direct mail to non-active patient portal increased enrollment of traditionally under-represented groups, including both women and African Americans. Conclusion: An electronic medical record–based recruitment strategy that utilized the electronic medical record for participant identification and postal mailing for participant outreach was cost-effective and increased participation of under-represented groups. This hybrid strategy represents a promising approach to improve the timely execution and broad generalizability of future clinical trials.

Rapid Adoption of a Serious Illness Conversation Electronic Medical Record Template: Lessons Learned and Future Directions

2020 ◽  
Vol 23 (2) ◽  
pp. 159-161 ◽  
Author(s):  
Erica Wilson ◽  
Rachelle Bernacki ◽  
Joshua R. Lakin ◽  
Corinne Alexander ◽  
Vicki Jackson ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Lessons Learned ◽  
Future Directions ◽  
Serious Illness

Recruitment lessons learned from a tailored web-based health intervention Project Y.E.A.H. (Young Adults Eating and Active for Health)

2015 ◽  
Vol 115 (5) ◽  
pp. 470-479 ◽  
Author(s):  
Onikia Brown ◽  
Virginia Quick ◽  
Sarah Colby ◽  
Geoffrey Greene ◽  
Tanya M. Horacek ◽  
...  
Keyword(s):  
College Students ◽  
Community Based Participatory Research ◽  
Health Intervention ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Recruitment Strategies ◽  
Web Based ◽  
Content Type ◽  
Recruitment Methods ◽  
Successful Recruitment

Purpose – Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach – The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings – Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications – This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value – This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

scholarly journals Strategy for addressing research-site overlap in pragmatic clinical trials: lessons learned from the NIH-DOD-VA Pain Management Collaboratory (PMC)

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Geda ◽  
◽  
Steven Z. George ◽  
Diana J. Burgess ◽  
Dylan V. Scarton ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Research Effort ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Exclusion Criteria ◽  
Eligibility Criteria ◽  
Recruitment Methods ◽  
Research Site ◽  
Pragmatic Clinical Trials

Abstract Background The Pain Management Collaboratory (PMC) is a multi-site network of pragmatic clinical trials (PCTs) focused on nonpharmacological approaches to pain management, conducted in health care systems of the US Department of Defense (DoD) and Department of Veterans Affairs (VA) and co-funded by the National Institutes of Health (NIH). Concerns about potential research-site overlap prompted the PMC investigator community to consider strategies to avert this problem that could negatively affect recruitment and contaminate interventions and thus pose a threat to trial integrity. Methods We developed a two-step strategy to identify and remediate research-site overlap by obtaining detailed recruitment plans across all PMC PCTs that addressed eligibility criteria, recruitment methods, trial settings, and timeframes. The first, information-gathering phase consisted of a 2-month period for data collection from PIs, stakeholders, and ClinicalTrials.gov. The second, remediation phase consisted of a series of moderated conference calls over a 1-month time period to develop plans to address overlap. Remediation efforts focused on exclusion criteria and recruitment strategies, and they involved collaboration with sponsors and stakeholder groups such as the Military Treatment Facility Engagement Committee (MTFEC). The MTFEC is comprised of collaborating DoD and university-affiliated PIs, clinicians, and educators devoted to facilitating successful pragmatic trials in DoD settings. Results Of 61 recruitment sites for the 11 PMC PCTs, 17 (28%) overlapped. Four PCTs had five overlapping Military Treatment Facilities (MTFs), and eight PCTs had 12 overlapping VA Medical Centers (VAMCs). We developed three general strategies to avoid research-site overlap: (i) modify exclusion criteria, (ii) coordinate recruitment efforts, and/or (iii) replace or avoid any overlapping sites. Potential overlap from competing studies outside of the PMC was apparent at 26 sites, but we were not able to confirm them as true conflicts. Conclusion Proactive strategies can be used to resolve the issue of overlapping research sites in the PMC. These strategies, combined with open and impartial mediation approaches that include researchers, sponsors, and stakeholders, provide lessons learned from this large and complex pragmatic research effort.

scholarly journals Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Amanda M Singrey ◽  
Kristin A Casper ◽  
Nicole V Brown ◽  
Bella H Mehta
Keyword(s):  
Smoking Cessation ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Home ◽  
Lessons Learned ◽  
Smoking Cessation Program ◽  
Original Research ◽  
Patient Centered Medical Home ◽  
Patient Portal ◽  
Patient Centered

Pharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management.   Type: Original Research

Impact of Electronic Medical Record Intervention on OP-29 and OP-30 Scores at St. Lukeʼs University Health Network

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S624
Author(s):  
Noel Martins ◽  
Christopher McCarthy ◽  
Jessica Sallit ◽  
Andrew Ivankovitz ◽  
Kathy Nunemacher ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Health Network

scholarly journals Recruiting for a pragmatic trial using the electronic health record and patient portal: successes and lessons learned

2018 ◽  
Vol 26 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Emily Pfaff ◽  
Adam Lee ◽  
Robert Bradford ◽  
Jinhee Pae ◽  
Clarence Potter ◽  
...  
Keyword(s):  
Pragmatic Trial ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Patient Portal ◽  
Recruitment Methods ◽  
Research Coordinator ◽  
Electronic Method ◽  
Electronic Health ◽  
Study Participants ◽  
Future Work

Abstract Objective Querying electronic health records (EHRs) to find patients meeting study criteria is an efficient method of identifying potential study participants. We aimed to measure the effectiveness of EHR-driven recruitment in the context of ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness)—a pragmatic trial aiming to recruit 15 000 patients. Materials and Methods We compared the participant yield of 4 recruitment methods: in-clinic recruitment by a research coordinator, letters, direct email, and patient portal messages. Taken together, the latter 2 methods comprised our EHR-driven electronic recruitment workflow. Results The electronic recruitment workflow sent electronic messages to 12 254 recipients; 13.5% of these recipients visited the study website, and 4.2% enrolled in the study. Letters were sent to 427 recipients; 5.6% visited the study website, and 3.3% enrolled in the study. Coordinators recruited 339 participants in clinic; 23.6% visited the study website, and 16.8% enrolled in the study. Five-hundred-nine of the 580 UNC enrollees (87.8%) were recruited using an electronic method. Discussion Electronic recruitment reached a wide net of patients, recruited many participants to the study, and resulted in a workflow that can be reused for future studies. In-clinic recruitment saw the highest yield, suggesting that a combination of recruitment methods may be the best approach. Future work should account for demographic skew that may result by recruiting from a pool of patient portal users. Conclusion The success of electronic recruitment for ADAPTABLE makes this workflow well worth incorporating into an overall recruitment strategy, particularly for a pragmatic trial.

scholarly journals LO64: A systematic review of interventions to influence opioid prescribing from the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S30-S31
Author(s):  
M. Tran ◽  
C. Thompson ◽  
C. Walsh ◽  
S. McLeod ◽  
B. Borgundvaag
Keyword(s):  
Emergency Department ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Care Coordination ◽  
The United States ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Data Transparency

Introduction: The opioid crisis has reached epidemic levels in Canada, driven in large part by prescription drug use. Emergency physicians are frequent prescribers of opioids; therefore, the emergency department (ED) represents an important setting for potential intervention to encourage rational and safe prescribing. The objective of this study was to systematically review the literature on interventions aimed to influence opioid prescribing in the ED. Methods: Electronic searches of Medline and Cochrane were conducted and reference lists were hand-searched. All quantitative studies published in English from 2009 to 2019 were eligible for inclusion. Two reviewers independently screened the search output to identify potentially eligible studies, the full texts of which were retrieved and assessed for inclusion. Outcomes of interest included opioid prescribing rate (proportion of ED visits resulting in an opioid prescription at discharge), morphine milligram equivalents per prescription and variability among prescribers. Results: The search strategy yielded 797 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 34 potentially relevant studies were retrieved in full text. Of these, 28 studies were included in the review. The majority (26, 92.9%) of studies were based in the United States and two (7.1%) were from Australia. Four (14.3%) were randomized controlled trials. The interventions were classified into six categories: prescribing guidelines (n = 10), regulation/rescheduling of opioids (n = 6), prescribing data transparency (n = 4), education (n = 4), care coordination (n = 3), and electronic medical record changes (n = 1). The majority of interventions reduced the opioid prescribing rate from the ED (21/28, 75.0%), although regulation/rescheduling of opioids had mixed effectiveness, with 3/6 (50%) studies reporting a small increase in the opioid prescribing rate post-intervention. Education had small yet consistent effects on reducing the opioid prescribing rate. Conclusion: A variety of interventions have attempted to improve opioid prescribing from the ED. These interventions include prescribing guidelines, regulation/rescheduling, data transparency, education, care coordination, and electronic medical record changes. The majority of interventions reduced the opioid prescribing rate; however, regulation/rescheduling of opioids demonstrated mixed effectiveness.

scholarly journals 2300

2017 ◽  
Vol 1 (S1) ◽  
pp. 5-6 ◽  
Author(s):  
Gillian Feldmeth ◽  
Leidy Gutierrez ◽  
Stacy Tessler Lindau ◽  
Jennifer A. Makelarski ◽  
Edward T. Naureckas ◽  
...  
Keyword(s):  
Minority Groups ◽  
Clinical Care ◽  
Research Participation ◽  
Target Population ◽  
Consent Form ◽  
Recruitment Strategy ◽  
Care Needs ◽  
Usual Practice ◽  
Recruitment Methods ◽  
Return Envelope

OBJECTIVES/SPECIFIC AIMS: To study the rate of recruitment to the Pulmonary Research Registry (PRR) at the University of Chicago using HealtheRx recruitment Versus usual practice. METHODS/STUDY POPULATION: CommunityRx is a health information technology, integrated with electronic medical record (EMR) platforms, that generates personalized referrals (“HealtheRxs”) for community-based programs and services that address basic and other health-related self-care needs. The target population included people ages 18 and older, English speaking, living in 1 of 16 ZIP codes on Chicago’s south and west sides (106 mi2) who received care at ≥1 of 28 CommunityRx partner sites and had a diagnosis of asthma or COPD. Between December 2015 and December 2016, information about pulmonary research participation opportunities was included on the HealtheRxs of eligible patients contemporaneously with usual registry recruitment methods. Usual methods, used since 2010 by the PRR group, included public advertisements requiring the patient to call the research team for more information and education of eligible patients identified during routine clinical care with a Pulmonary/Critical Care clinician or when enrolling in a pulmonary clinical trial. We hypothesized that, compared with usual recruitment practices, the HealtheRx recruitment strategy would increase the rate and decrease the per subject cost of patient recruitment to a prospective registry. Total annual recruitment costs for each method were calculated and divided by the number of consented PRR enrollees per method. RESULTS/ANTICIPATED RESULTS: Between December 22, 2015 and December 15, 2016 13,437 HealtheRxs (8762 for asthma, 3842 for COPD, and 833 for both asthma and COPD) were generated with the recruitment advertisement. In total, 41 patients responded to the ad and participated in the phone survey. In which 15 (36.5%) participants self-reported a diagnosis of asthma only (65% of all HealtheRxs with advertisement were for asthma only), 9 (22%) reported a diagnosis of COPD only (28.5% of all HealtheRxs with advertisement were for COPD only), and 17 (41.5%) reported diagnoses of both asthma and COPD (6.2% of all HealtheRxs with advertisement were for asthma and COPD). Most participants were female (n=28), non-Hispanic black (n=37), and not employed (n=39). The median age was 57. The majority (n=31) had never participated in health or medical research and was not aware of current opportunities to participate in research (n=25). All 41 participants expressed interest in joining PRR and were mailed a blank PRR consent form and a prepaid return envelope with their incentive check for the telephone survey. To date, 5 participants returned a signed consent form via mail and were enrolled in PRR. During the same period, 4 patients enrolled in PRR via usual recruitment methods. The cost per subject to enroll in PRR was $364.40 using the HealtheRx recruitment and $4590 using usual practice. DISCUSSION/SIGNIFICANCE OF IMPACT: NIH has called for innovation in research recruitment methodologies to increase enrollment especially of people who are under-represented in clinical trials research. This study demonstrates the feasibility and efficiency of using an EMR-integrated recruitment method to enroll people of under-represented minority groups to a research registry.

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