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Home > "C" Clinical Trials Conditions > Computer-Assisted Access to Specialist Expertise  Computer-Assisted Access to Specialist Expertise
Computer-Assisted Access to Specialist Expertise
For Condition: Diabetes melitus
Status: No longer recruiting
Sponsor(s): Department of Veterans Affairs , Department of Veterans Affairs Health Services Research and Development Service,Department of Veterans Affairs - Veterans Integrated Services Network
Synopsis: The expansion of local access to primary care by means of community-based outpatient clinics (CBOCs) complicates the already problematic issue of access of patients and primary care providers (PCPs) to specialists. There have been few studies in the VA concerning the interface between primary and secondary care, especially for CBOCs that lack specialists on site (i.e., where direct access to specialists is problematic). Informal consultation has been proposed as an efficient and relatively inexpensive method of providing specialist expertise. We will use a system to facilitate interaction between primary care providers and specialists--computer-assisted access to specialist expertise (CASE). The care of patients with diabetes mellitus, a disorder affecting all organ systems, constitutes a model in which to evaluate the primary care/secondary care interface. Such complex patients may benefit from the input of multiple specialists and primary care providers must determine the need for and coordinate the input from those multiple specialists. With that in mind, the three objectives of the study are: 1) to assess the impact of computer-assisted access to specialist expertise (CASE) on process of care for patients with diabetes mellitus; 2) to assess the impact of CASE on outcomes of care at the patient level (clinical outcomes and satisfaction), provider level (satisfaction) and the system level (health services utilization and costs); and 3) to characterize the consultation-referral process in community-based outpatient clinics (CBOCs). Study 1: randomized controlled trial with access to the CASE system constituting the intervention and a descriptive study of the consultation process. This system allows PCPs to leave a question for a specialist via voice mail and be notified when the specialist has answered the question. The major outcome variables will be the consultation type, adherence to diabetes practice guidelines, clinical outcome of diabetes care (glycemic control, blood pressure, LDL cholesterol levels, angiotensin-converting enzyme inhibitor therapy for diabetic nephropathy), patient satisfaction, and provider satisfaction. Study 2: pretest-posttest design of CASE access for primary care providers in the Black Hills VA Healthcare System. Primary outcome measure: number of fee basis referrals in selected subspecialties.
Details:
Eligibility:
Study Type: Interventional, Educational/Counseling/Training, Randomized, Open Label, Placebo Control, Single Group Assignment
Minimum Age/Maximum Age: /
Genders: Both
Protocol Entry Criteria: Primary Care Providers in VA community-based outpatient clinics; patients receiving primary care in VA community-based outpatient clinics.
Total Enrollment: 10000
Location and Contact Information:
Louis Stokes VA Medical Center
Cleveland, Ohio, 44106-3800
United States
Additional Information:
Study ID Numbers: VCR 99-008;
Study Start Date: January 2000
Record last reviewed: September 2002
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00013117
Other Diabetes Melitus Studies:
1. Computer-Assisted Access to Specialist Expertise
Related Studies:
Other Diabetes melitus Clinical Trials
Other Ohio Clinical Trials
Other Cleveland Clinical Trials
Computer-Assisted Access to Specialist Expertise
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