Using an AI tool to prioritize specialty referrals for primary care patients
Efficacy of an Artificial Intelligence Algorithm for Gatekeeping in Referrals From Primary Care to Specialized Care: a Randomized Controlled Trial
This project will test whether an AI tool can sort and prioritize specialty-care referrals so primary care patients with chronic conditions get more timely and appropriate specialist access.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 934 (estimated) |
| Sex | All |
| Sponsor | Hospital de Clinicas de Porto Alegre Academic / other |
| Locations | 1 site (Porto Alegre, Rio Grande do Sul) |
| Trial ID | NCT07019116 on ClinicalTrials.gov |
What this trial studies
Investigators will randomly implement an AI triage algorithm across selected specialty waitlists in the electronic referral system used in Rio Grande do Sul, Brazil, and compare outcomes to standard gatekeeping. Eligible referrals come from municipal primary care clinics for selected specialties; referrals with attachments, prior discussion rounds, or AI confidence below 80% are excluded. The trial will measure how the AI affects referral authorization patterns, wait times, specialist visit appropriateness, and backlog size. Implementation is centered at the Central de Regulação Ambulatorial in Porto Alegre and coordinated with the state health department.
Who should consider this trial
Good fit: This applies to referrals from selected specialty waitlists submitted by primary care clinics across municipalities in Rio Grande do Sul, mainly for patients with chronic conditions.
Not a fit: Referrals that include attachments or previous rounds of discussion, or any referral where the AI gives under 80% confidence, are excluded and would not benefit from the tool in this project.
Why it matters
Potential benefit: If successful, the AI could speed care for high-risk patients, reduce unnecessary specialist visits, and shrink the referral backlog.
How similar studies have performed: Some AI triage tools have shown promise in other referral and emergency-triage settings, but randomized implementation of gatekeeping AI across a large public referral system is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * All referrals from a given specialty (waitlist) will be eligible. * Specialties will be selected following Rio Grande do Sul Health Department priorities. Exclusion Criteria: * Referrals that the AI algorithm can not evaluate. These include referrals with attachments (further information in image or PDF files) and referrals with previous rounds of discussion. * Referrals in which the algorithm has low confidence in the decision (i.e., informed data lead to a decision with a probability below 80%) will not be included in the study.
Where this trial is running
Porto Alegre, Rio Grande do Sul
- Central de Regulação Ambulatorial — Porto Alegre, Rio Grande do Sul, Brazil (Recruiting)
Study contacts
- Principal investigator: Dimitris V. Rados, Ph.D. — TelessaúdeRS
- Study coordinator: Dimitris V Rados, Ph.D.
- Email: drados@hcpa.edu.br
- Phone: +555133082092
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.