Using a social risk score and decision support tool to improve care for disadvantaged patients
Piloting a Clinical Decision Support Tool to Identify and Refer Patients With Social Needs to Community-based Organizations
This study is testing a new tool to help doctors better care for patients from racial and ethnic minorities with chronic diseases by identifying their social needs and connecting them to community resources.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 600 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Johns Hopkins University Academic / other |
| Locations | 5 sites (Baltimore, Maryland and 4 other locations) |
| Trial ID | NCT05574699 on ClinicalTrials.gov |
What this trial studies
This project aims to enhance care for racial and ethnic minorities with chronic diseases by implementing a social risk score and clinical decision support (CDS) tool in primary care clinics. The CDS tool will help healthcare providers identify patients with social needs and facilitate referrals to community-based organizations. The study will assess the impact of this tool on patient outcomes and clinical workflows compared to standard care. The implementation will take place in selected clinics within the Johns Hopkins Health System.
Who should consider this trial
Good fit: Ideal candidates for this study are adult African-American patients with low income who are receiving care at the participating clinics.
Not a fit: Patients who may not benefit from this study include children, individuals with high income, and those of races other than African American.
Why it matters
Potential benefit: If successful, this approach could significantly improve health outcomes for socially disadvantaged patients with chronic diseases.
How similar studies have performed: Other studies have shown promise in using social risk assessments to improve healthcare delivery, making this approach both relevant and potentially impactful.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adult (18+ years old) African-American patients with low income at each clinic Exclusion Criteria: * Children are excluded from this study. Individuals with high levels of income, and those with race other than African American
Where this trial is running
Baltimore, Maryland and 4 other locations
- Johns Hopkins GreenSpring Station — Baltimore, Maryland, United States (Recruiting)
- Johns Hopkins Community Physicians - EBMC — Baltimore, Maryland, United States (Recruiting)
- Johns Hopkins Community Physicians - Remington — Baltimore, Maryland, United States (Recruiting)
- Johns Hopkins Bayview Medical Center - Comprehensive Care Practice — Baltimore, Maryland, United States (Recruiting)
- Johns Hopkins JHOC-GIM Clinic — Baltimore, Maryland, United States (Recruiting)
Study contacts
- Principal investigator: Elham Hatef, MD, MPH — Johns Hopkins University
- Study coordinator: Elham Hatef, MD, MPH
- Email: ehatef1@jhu.edu
- Phone: 410-978-8006
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.