Facilitating Access to Specialty Treatment
Utilizing Mobile Health to Expedite Access to Specialty Care for Youth Presenting to the Emergency Department With Concussion at Highest Risk of Developing Persisting Symptoms
Children's Hospital of Philadelphia
210 participants
Mar 11, 2024
INTERVENTIONAL
Conditions
Summary
The goal of this hybrid implementation-effectiveness study is to evaluate the effectiveness (hastened recovery times) and feasibility (fidelity in connecting to concussion specialty care) of a novel mobile health intervention, designed to reduce disparities in access to specialty care through the use of remote patient monitoring (RPM) to facilitate care hand-off from the emergency department (ED) to concussion specialty care. Participants will report their symptoms and activity once daily through RPM chat technology that is linked to their electronic health record and prompts referral to specialty care.
Eligibility
Inclusion Criteria7
- Males and females age 13 - 18
- Present to the Children's Hospital of Philadelphia (CHOP) Emergency Department (ED) within 72 hours of head injury
- Meet criteria for concussion as defined by the most recent International Consensus Statement on Concussion
- Own a smartphone
- Meet criteria for moderate-to-high risk for Persistent Post-Concussion Symptoms according to 5P rule (score \>3/12)
- Child meets the study eligibility criteria
- ED or specialty provider caring for at least one patient via the mobile Health (mHealth)-facilitated care handoff strategy
Exclusion Criteria9
- Glasgow Coma Scale score \<13
- Lower extremity trauma
- A prior concussion within 1 month
- Non-English speaking
- Admission to the hospital at the initial head injury visit
- Previously enrolled in the study
- Inability to complete study procedures.
- Non-English speaking
- Non-English speaking
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Interventions
Participants will be prompted to report current symptoms and activity once a day via remote patient monitoring chat technology for up to 28 days following injury. Patients with either escalating or plateauing symptoms will be flagged, with an electronic alert sent via the electronic health record to a nurse navigator. The nurse navigator will have access to the symptom data and facilitate scheduling an in person or telehealth specialist visit as indicated. Symptoms will continue to be monitored through the 28-day acute study period with additional clinical visits occurring according to clinical need.
Locations(1)
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NCT05741411