Status:

COMPLETED

MORE-PC: A 30-day Automated SMS Program to Support Post-discharge Transitions of Care

Lead Sponsor:

University of Pennsylvania

Collaborating Sponsors:

UnitedHealth Group

Conditions:

Care Transitions

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

This study will evaluate a 30-day post-discharge intervention using an automated SMS platform to monitor patients and facilitate communication with their primary care practice. The population will be ...

Detailed Description

Background: Current models of post-discharge care management are time and labor intensive, limited in scope, and inconvenient from the patient perspective, particularly when they have a need arise. A...

Eligibility Criteria

Inclusion

  • The study subjects will be medium to high risk (UPHS risk score 4 and above; an internally developed and validated score assessing a patient's risk for readmission) adult (age ≥ 18) patients of the Penn Primary Care Practices who are discharged home from acute inpatient care in the broad Philadelphia region as identified in HealthShare Exchange (HSX) reports

Exclusion

  • This study will exclude discharges who do not meet criteria for transitional care management. These criteria include discharges after 1) planned chemotherapy admissions; 2) certain scheduled surgeries, including spinal surgery, joint replacements, gastric bypass, transurethral resection of the prostate, gynecologic surgeries, and transplants; 3) obstetrics admissions.
  • We will exclude patients from re-enrollment during the study period (once they have been enrolled once, they will not be enrolled again). We will also exclude patients being discharged to home hospice.

Key Trial Info

Start Date :

March 29 2022

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

February 3 2023

Estimated Enrollment :

5000 Patients enrolled

Trial Details

Trial ID

NCT05245773

Start Date

March 29 2022

End Date

February 3 2023

Last Update

February 27 2023

Active Locations (1)

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1

University of Pennsylvania School of Medicine

Philadelphia, Pennsylvania, United States, 19104