An interventional study of Health-related social needs decision support system in Emergency Service, Hospital and Social Determinants of Health, sponsored by Indiana University. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-03-31.
Sponsored by Indiana University · Not applicable, Interventional, and Health services research
The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:
The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.
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This study's enrollment of 518,512 is above the median of 145 across 931 interventional studies indexed under Emergencies.
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Of its 142 completed or terminated interventional studies of FDA-regulated products, 112 (79%) have results posted.
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Exclusion Criteria:
Adult ED patients seeking care the ED site with the health-related social needs decision support system live.
Other: Health-related social needs decision support system
Adult ED patients created using statistical matching from ED sites in the same metropolitan area.
The clinical decision support intervention will present emergency department clinicians at an Indianapolis, IN ED with a likelihood score for an adult patient screening positive for the following health-related social needs (HRSNs): housing instability, food insecurity, transportation barriers, financial strain, and history of legal involvement. For each HRSN, the likelihood of screening positive is reported as "high", "medium", or "low". These categorizations are the product of logistic regression models. The clinical decision support intervention will be delivered through an existing FHIR (Fast Healthcare Interoperability Resources) standards-based clinical decision support platform.
Percent of emergency department encounters screened for health-related social needs (HRSNs)
The numerator will be an emergency department encounter with any indication of HRSN screening using any tool or questionnaire, regardless of patient completion or results. The denominator will be all eligible ED encounters.
Time frame: At time of emergency department encounter (or within 24 hours)
Percent of emergency department encounters that were referred for health-related social needs (HRSNs) services
The numerator will be emergency department encounters with a referral to social worker, case management, community health workers, or related services within 24 hours of the ED encounter. The denominator will be all eligible ED encounters
Time frame: At time of emergency department encounter (or within 24 hours)
Percent of encounters with an emergency department revisit measured at 3 days
The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 3 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.
Time frame: within 3 days of emergency department encounter
Percent of encounters with an emergency department revisit measured at 7 days
The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 7 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.
Time frame: within 7 days of emergency department encounter
Percent of encounters with an emergency department revisit measured at 30 days
The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 30 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator
Time frame: within 30 days of emergency department encounter
Percent of emergency department encounters with primary care visit within 7 days of an ED encounter
The numerator will include all emergency department encounters with a completed family medicine, internal medicine, OBGYN, or geriatrician visit64 within 7 days of the ED visit. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.
Time frame: within 7 days of emergency department visit
Percent of emergency department encounters where the health-related social needs (HRSN) decision support system intervention was accessed.
The numerator will include encounters with access of the social needs section (containing the risk prediction scores) of the decision support system intervention during the study visit (defined as within 24 hours). Access will be defined as record of the end user visiting the HRSN page in the system user logs. The denominator will be all eligible ED encounters. Limited to the intervention site only.
Time frame: At time of emergency department encounter (or within 24 hours)
Percent of emergency department encounters where the clinical decision support platform was accessed
The numerator will include encounters with access of clinical decision support platform during the study visit (defined as within 24 hours). Access will be defined as record of the end user visiting initiating a request to the decision support application from the EHR. Any portion of the decision support platform (not just the health-related social needs section) is included. The denominator will be all eligible ED encounters (see Inclusion criteria, above). Limited to the intervention site only
Time frame: At time of emergency department encounter(or within 24 hours)
Plan to share: No — All data produced during the project will be preserved, but raw and derived data (at the patient-level) will not be posted publicly because of our use of secondary data from privately held electronic health record and health information exchange systems. Due to the data use restrictions put in place by consortium agreements among the health system partners that contribute EHR data to the Indiana Network for Patient Care, patient-level data cannot be shared or disseminated outside this project. However, de-identified derived data (at the patient-level) used in this study may be shared with investigators whose formal request is approved by the data owners. Requests can be sent to askRDS@regenstrief.org. Access to these data requires investigator support for use and a signed data access agreement between the Regenstrief Institute and the investigator's institution.
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