On-demand telemedicine for people who frequently use the ER
An Integrated, Virtual and On-Demand Solution to Avoid ED Utilization
NA · Geisinger Clinic · NCT07042477
This project tries on-demand virtual visits to see if they reduce ER visits for Geisinger-insured adults who repeatedly use the emergency department and have physical and behavioral health needs.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 3200 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Geisinger Clinic (other) |
| Locations | 1 site (Danville, Pennsylvania) |
| Trial ID | NCT07042477 on ClinicalTrials.gov |
What this trial studies
Adults who are high emergency department utilizers and have co-occurring physical and behavioral health correlates will be randomized to full access to an integrated, on-demand telemedicine program or to usual care. Analyses will follow an intent-to-treat approach and the primary outcome is the number of ED visits in the 120 days after the first Best Practice Alert (BPA) firing. The team plans to enroll up to 3,200 patients, though randomization may end on December 31, 2025 due to system constraints. The planned sample provides 80% power to detect a 35% relative reduction in ED use with a two-tailed alpha of 0.15, assuming 40% program compliance.
Who should consider this trial
Good fit: Adults 18 or older who are Geisinger Health Plan members with a Geisinger PCP, have had four or more Geisinger ED visits in the past six months, are being seen at one of the listed Geisinger EDs, and do not meet any exclusion criteria are the intended participants.
Not a fit: Patients who require inpatient care, are coded Level 1 (life‑saving measures), have alcohol or substance-related disorders, have intellectual disability or traumatic brain injury, are actively seeing a behavioral health provider, or are seen in departments deemed ineligible are excluded and unlikely to benefit from this outpatient telemedicine intervention.
Why it matters
Potential benefit: If successful, the program could reduce emergency department visits and improve timely access to care through virtual visits.
How similar studies have performed: Previous telemedicine programs for frequent ED users have shown mixed results, with some reductions in ED use in certain settings but no uniform, definitive success across populations.
Eligibility criteria
Show full inclusion / exclusion criteria
Patient presents to the ED and meets the following criteria: Inclusion Criteria: * 18+ years old * 4+ Geisinger ED visits in the last 6 months * Geisinger Health Plan (GHP) insurance member * Has a Geisinger PCP * Patient is being seen at one of the following facilities: Geisinger Lewistown Hospital, Geisinger Medical Center, Geisinger Bloomsburg Hospital, Geisinger Jersey Shore Hospital, Geisinger Community Medical Hospital, Geisinger Wyoming Valley, Geisinger Medical Center Muncy, Geisinger Shamokin Ach Hospital, Geisinger South Wilkes Barre Exclusion Criteria: * Patient being seen in departments determined ineligible by the study team * Patient is diagnosed with alcohol and substance-related disorders * Patient is going to receive inpatient care * Patient is coded in the ED as Level 1 (i.e., seeking life-saving measures) * Patient has an Intellectual Disability or Traumatic Brain Injury * Patient is actively seeing a BH provider
Where this trial is running
Danville, Pennsylvania
- Geisinger Clinic — Danville, Pennsylvania, United States (RECRUITING)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Behavioral Intervention, Emergency Department Visits, Telemedicine