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Timely Nudge About Lab Results to Increase myGeisinger Uptake

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ClinicalTrials.gov Identifier: NCT04333199
Recruitment Status : Completed
First Posted : April 3, 2020
Results First Posted : May 3, 2021
Last Update Posted : June 11, 2021
Sponsor:
Information provided by (Responsible Party):
Amir Goren, Geisinger Clinic

Brief Summary:
The purpose of the current study is to test whether sending email communications in a timely manner - when patients have laboratory results available to view on the myGeisinger patient portal - increases enrollment in the portal.

Condition or disease Intervention/treatment Phase
Telehealth Health Behavior Behavioral: Timely Behavioral: Transparency Behavioral: Foot-in-the-door Not Applicable

Detailed Description:

Online patient portals are convenient tools that improve patient access to healthcare services while often reducing burden to both patients and providers. However, many patients have not enrolled in such portals, including Geisinger's patient portal, known as myGeisinger.

The purpose of the current study is to test whether sending myGeisinger enrollment information in a timely manner - when the benefits of enrolling are most readily available - increases enrollment. Specifically, messages will be timely in terms of lab test results having just been made available online, with the added benefit that patients can view their results prior to receiving them via mail. Unenrolled patients who recently had a laboratory procedure ordered and whose results are now ready for sharing will be informed via email that their lab results are available. At the same time, these patients will be reminded that these results can be viewed online through myGeisinger.

The primary outcome measure of interest, myGeisinger enrollment rates, will be compared between the emailed population and a control group that similarly has lab results available but will not be contacted. In addition, two different versions of the email communication will be tested. One will highlight that the patient will have to go through a sign-up process before viewing test results (in the service of transparency). The other will provide a presumed direct link to view those results, via a button that potentially serves as a pre-commitment step to undergo the registration process ("foot in the door" effect). Secondary analyses will assess differences in enrollment rates as well as unsubscribe rates between the email versions. Exploratory analyses will further examine differences in the rates at which patients opened and clicked on enrollment links within the two emails. Statistical analyses will employ generalized linear models with a binary distribution and log-link function.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5012 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Every day within the designated study period, an email will be sent to patients who 1) fulfill inclusion criteria, 2) have been randomized to one of the email conditions (rather than the control group), and 3) have not already been randomized to a study condition on a previous day (i.e. no patient will be emailed for this study twice).
Masking: Single (Participant)
Masking Description: Participants (i.e., patients) will not be informed specifically of their assignment to different arms throughout the study.
Primary Purpose: Health Services Research
Official Title: Nudging myGeisinger Enrollment Using Timely Email Messaging Reminding Patients of Lab Results Available
Actual Study Start Date : May 18, 2020
Actual Primary Completion Date : June 8, 2020
Actual Study Completion Date : July 1, 2020

Arm Intervention/treatment
No Intervention: Control
Patients do not receive an email
Experimental: Timely nudge - view results
Patients are emailed about myGeisinger when they have a lab result ready to view. The email includes a "View My Lab Results" button, which encourages them to click as a pre-commitment step that then brings them to the myGeisinger sign-up page.
Behavioral: Timely
Email

Behavioral: Foot-in-the-door
Email

Experimental: Timely nudge - get started
Patients are emailed about myGeisinger when they have a lab result ready to view. The email includes a "Get Started With myGeisinger" button that is transparent about the next step in the process, before the patient can view test results.
Behavioral: Timely
Email

Behavioral: Transparency
Email




Primary Outcome Measures :
  1. Enrollment - Timely Email (Combined Email Arms) vs. no Intervention [ Time Frame: 1 week post-intervention ]
    Patient enrolled in myGeisinger (yes / no)


Secondary Outcome Measures :
  1. Enrollment - Email Including a "Get Started" Button vs. a "View Results" Button [ Time Frame: 1 week post-intervention ]
    Patient enrolled in myGeisinger (yes / no)

  2. Email Opened - Email Including a "Get Started" Button vs. a "View Results" Button [ Time Frame: 1 week post-intervention ]
    Email was opened (yes / no)

  3. Link Clicked - Email Including a "Get Started" Button vs. a "View Results" Button [ Time Frame: 1 week post-intervention ]
    Link / button to start the enrollment process was clicked (yes / no)

  4. Unsubscribed - Email Including a "Get Started" Button vs. a "View Results" Button [ Time Frame: 1 month post-intervention ]
    Patient unsubscribed from these email communications (yes / no)

  5. Enrollment - Timely Email (Combined Email Arms) vs. no Intervention [ Time Frame: 1 month post-intervention ]
    Patient enrolled in myGeisinger (yes / no)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Geisinger patient for whom a lab was ordered within 30 days prior to email date
  • Patient's lab test result released day before email date

Exclusion Criteria:

  • Patient already enrolled in myGeisinger
  • Patient has already declined myGeisinger

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04333199


Locations
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United States, Pennsylvania
Geisinger
Danville, Pennsylvania, United States, 17822
Sponsors and Collaborators
Geisinger Clinic
Investigators
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Principal Investigator: Amir Goren, PhD Geisinger Clinic
  Study Documents (Full-Text)

Documents provided by Amir Goren, Geisinger Clinic:
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Responsible Party: Amir Goren, Program Director, Behavioral Insights Team, Geisinger Clinic
ClinicalTrials.gov Identifier: NCT04333199    
Other Study ID Numbers: 2020-0316
First Posted: April 3, 2020    Key Record Dates
Results First Posted: May 3, 2021
Last Update Posted: June 11, 2021
Last Verified: May 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: 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.
Supporting Materials: Analytic Code
Time Frame: The data will become available after publication of study results in a scientific journal and will be available as long as the Open Science Framework hosts the data.
Access Criteria: The data on the Open Science Framework will be open to anyone requesting that information.
URL: http://osf.io

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Amir Goren, Geisinger Clinic:
Behavioral Economics
Patient Portal