Improving ED communication when your diagnosis is uncertain

Targeted EHR-based Communication of Diagnostic Uncertainty (TECU) in the ED: An Effectiveness Implementation Trial

NIH-funded research Thomas Jefferson University · NIH-11143103

This project uses the electronic health record to prompt emergency clinicians to give clear explanations, a printed handout, and follow-up notes to patients who leave the ED without a definite diagnosis.

Quick facts

Grant typeNIH-funded research
Study typeNIH-funded research
Funding institutionThomas Jefferson University NIH-funded
Lab location1 site (Philadelphia, United States)
Project IDNIH-11143103 on NIH RePORTER

What this research studies

If you are discharged from the emergency department without a clear diagnosis, the system will detect that your clinician recorded an uncertain diagnosis and prompt them to discuss what that means for you and your next steps. It will automatically print a one-page patient handout and a clinician checklist to guide the discharge conversation, and it will send a message to your primary care provider to help arrange follow-up. Clinicians will receive training in communicating uncertainty and the trial will compare outcomes at sites using the EHR-triggered package versus usual discharge care. The focus is on making discharge instructions clearer, safer, and easier to follow when the diagnosis is still uncertain.

Who could benefit from this research

Good fit: Patients discharged from participating emergency departments who leave without a definitive diagnosis are the intended participants.

Not a fit: Patients who are admitted to the hospital, leave the ED with a clear diagnosis, or receive care outside participating EDs are unlikely to be affected by this project.

Why it matters

Potential benefit: If successful, this could make discharge conversations and written instructions clearer, improve follow-up care, and reduce safety problems for patients sent home without a definitive diagnosis.

How similar studies have performed: Prior AHRQ-funded work developed checklists, training, and patient handouts that showed promise, while the planned EHR-triggered implementation is a newer step to deliver those supports automatically.

Where this research is happening

Philadelphia, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.