Testing health information technology tools to facilitate health insurance support: a protocol for an effectiveness-implementation hybrid randomized trial

Implementation Science

Rachel Gold²  Marla Dearing¹  Rose L. Harding³  Megan Hoopes¹  Aleksandra Sumic¹  Deborah Cohen³  Miguel Marino³  Christine Nelson¹  Heather Angier³  Sonja Likumahuwa-Ackman³  Nathalie Huguet³  Jennifer E. DeVoe¹ 

[1] OCHIN, Inc., 1881 SW Naito Parkway, Portland 97201, OR, USA;Center for Health Research Northwest, Kaiser Permanente, 3800 N. Interstate Avenue, Portland 97227, OR, USA;Department of Family Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland 97239, OR, USA

关键词: Hybrid design;    Primary care;    Health information technology;    Medicaid;    Health insurance;    Cancer screening;   

Others  :  1235455
DOI  :  10.1186/s13012-015-0311-4

 received in 2015-07-30, accepted in 2015-08-11,  发布年份 2015

【 摘 要 】

Background

Patients with gaps in health insurance coverage often defer or forgo cancer prevention services. These delays in cancer detection and diagnoses lead to higher rates of morbidity and mortality and increased costs. Recent advances in health information technology (HIT) create new opportunities to enhance insurance support services that reduce coverage gaps through automated processes applied in healthcare settings. This study will assess the implementation of insurance support HIT tools and their effectiveness at improving patients’ insurance coverage continuity and cancer screening rates.

Methods/design

This study uses a hybrid cluster-randomized design—a combined effectiveness and implementation trial—in community health centers (CHCs) in the USA. Eligible CHC clinic sites will be randomly assigned to one of two groups in the trial’s implementation component: tools + basic training (Arm I) and tools + enhanced training + facilitation (Arm II). A propensity score-matched control group of clinics will be selected to assess the tools’ effectiveness. Quantitative analyses of the tools’ impact will use electronic health record and Medicaid data to assess effectiveness. Qualitative data will be collected to evaluate the implementation process, understand how the HIT tools are being used, and identify facilitators and barriers to their implementation and use.

Discussion

This study will test the effectiveness of HIT tools to enhance insurance support in CHCs and will compare strategies for facilitating their implementation in “real-world” practice settings. Findings will inform further development and, if indicated, more widespread implementation of insurance support HIT tools.

Trial registration

Clinical trial NTC02355262

【 授权许可】

   
2015 DeVoe et al.

【 图 表 】

Fig. 1.

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