Recruiting

Observational Study

Sponsor:

Intermountain Health Care, Inc.

Code:

NCT04606849

Conditions

Pneumonia

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Accepted

Interventions

Physician Survey

ePNa-CheXED

Study Details

Brief summary:

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.

Conditions

Pneumonia

Study ID

NCT04606849

Start date

Nov 12, 2020

Status verified date

Aug, 2024

Completion date

Sep 30, 2024

Anticipated

Primary completion date

Sep 30, 2024

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Accepted

Inclusion Criteria:

  • 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

Survey All physicians and advanced practice clinicians who are employed and actively seeing patients in the 4 Utah Valley Instacares

Exclusion Criteria:

  • 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).

Survey No providers will be excluded from the survey invitation

Study Design

Enrollment

4000 participants

Anticipated

Allocation

Non randomized

Intervention Model

Parallel Assignment

Primary purpose

Health Services Research

Interventions and Outcome Measures

Arms

other: Physician Survey

A modified version of a previously validated REDCap questionnaire will be administered to Instacare clinicians in the cluster where ePNa-CheXED was deployed via email at 6 months after ePNa-CheXED implementation. Our questionnaire includes questions on respondent demographics and Likert-style questions about respondents' 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

other: Adapt ePNa-CheXED for InstaCares

Adapt ePNa-CheXED for Instacares and after in silico testing, pilot it among "super user" clinicians during Instacare shifts and assess its usability. ePNa needs adaptation for more limited patient data available in Instacare clinics, calibration of severity measures for lower observed mortality, and a chest imaging prompt in patients with pneumonia signs and symptoms. 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).

Interventions

Physician Survey

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

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).

Primary outcome measure

  • ePNa utilization and impact on the UCC clinical environment [ Time Frame: through study completion, year 3 of the study ]

Central Contacts and Locations

Locations

American Fork Instacare

Recruiting

American Fork, Utah, United States, 84003

Contacts

Layton Instacare

Recruiting

Layton, Utah, United States, 84041

Contacts

Lehi Instacare

Recruiting

Lehi, Utah, United States, 84043

Contacts

Utah Valley Instacare

Recruiting

Provo, Utah, United States, 84604

Contacts

Saratoga Springs Instacare

Recruiting

Saratoga Springs, Utah, United States, 84045

Contacts

Spanish Fork Instacare

Recruiting

Spanish Fork, Utah, United States, 84660

Contacts

More Information

Sponsor

Intermountain Health Care, Inc.

Last update posted

Aug 26, 2024

Last verified

Aug, 2024

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by Intermountain Health Care, Inc. on 2024-08-26.