Electronic Health Record Alerts for Kidney Disease

AC
Overseen ByAlexander Chang, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Geisinger Clinic
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether electronic alerts to doctors can increase referrals of patients with signs of kidney disease to specialists. It targets individuals with blood and protein in their urine, early indicators of glomerulonephritis, a type of kidney inflammation. Doctors of one patient group will receive Electronic Health Record alerts, while another group will receive regular care without alerts. This trial suits patients seeing a Geisinger primary care doctor who have recent tests showing blood and protein in their urine but have not yet consulted a kidney specialist. As an unphased trial, it offers patients the chance to contribute to innovative research that could improve early detection and care of kidney disease.

Do I have to stop taking my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this electronic health record alert is safe for patients?

Past studies have safely used electronic health record (EHR) alerts in healthcare. Research has shown that EHR alerts can identify and manage kidney disease without harming patients. For instance, one study found that EHR alerts for sudden kidney problems resulted in health outcomes similar to regular care, indicating no additional risks.

Another study demonstrated that EHR alerts enabled doctors to refer patients to specialists more quickly without negative effects. This suggests that EHR alerts are generally safe and can be integrated into patient care without increasing the risk of problems. Overall, evidence indicates that using EHR alerts does not raise the risk of harm to patients.12345

Why are researchers excited about this trial?

Researchers are excited about the Electronic Health Record (EHR) alert system for kidney disease because it offers real-time, proactive intervention. Unlike traditional treatments that primarily focus on managing symptoms after they appear, this system aims to alert primary care providers (PCPs) as soon as potential kidney issues are detected in patient data. This early warning can lead to quicker intervention, potentially slowing disease progression and improving patient outcomes. By integrating seamlessly into existing healthcare technologies, the EHR alert system could enhance the efficiency and effectiveness of kidney disease management.

What evidence suggests that this EHR alert is effective for improving PCP referral patterns for kidney disease?

This trial will compare the effectiveness of Electronic Health Record (EHR) alerts with usual care in managing kidney disease. Research has shown that EHR alerts can enhance kidney disease care. These automated alerts assist doctors in diagnosing chronic kidney disease (CKD) earlier and increase patient referrals to specialists. Studies have found that EHR alerts can also boost the number of patients receiving crucial treatments like dialysis. In some cases, these alerts have identified acute kidney injury (AKI), a sudden condition affecting kidney function. Overall, EHR alerts offer a promising method to improve kidney disease management by ensuring timely medical care.14678

Are You a Good Fit for This Trial?

This trial is for adults (18 or older) who see a Geisinger primary care doctor and have recent test results showing both blood and moderate to high levels of protein in their urine, which are signs of possible kidney disease.

Inclusion Criteria

I am 18 years old or older.
* Patients receiving care from any Geisinger primary care provider (record of an encounter with a Geisinger PCP within the last 2 years from date of survey implementation)
* Patients with high-risk glomerulonephritis features i.e. positive test results for hematuria (urine dipstick result with blood 1+ or greater) and proteinuria (2+ or 3+ protein on dipstick or ACR≥300 mg/g or PCR ≥500 mg/g) collected within 12 months of index date.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Intervention

Primary care providers are randomized to receive or not receive an EHR alert during patient visits, prompting referral to Nephrology.

1 month
1 visit (in-person)

Follow-up

Participants are monitored for nephrology referral completion and other exploratory outcomes.

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Electronic Health Record alert

Trial Overview

The study is testing whether sending electronic health record alerts to primary care doctors helps increase referrals to kidney specialists for patients at risk of glomerulonephritis. The impact on referral rates will be measured.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: Patients randomized to have PCP receive EHR AlertExperimental Treatment1 Intervention
Group II: Patients receiving usual careActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Geisinger Clinic

Lead Sponsor

Trials
159
Recruited
1,976,000+

Novartis

Industry Sponsor

Trials
1,646
Recruited
2,778,000+
Vasant Narasimhan profile image

Vasant Narasimhan

Novartis

Chief Executive Officer since 2018

MD from Harvard Medical School, Bachelor's in Biological Sciences from University of Chicago, Master's in Public Policy from John F. Kennedy School of Government

Shreeram Aradhye profile image

Shreeram Aradhye

Novartis

Chief Medical Officer since 2022

MD from Yale University, MSc in Clinical Epidemiology from University of Pennsylvania

Citations

Electronic Health Record Population Health Management for ...

Large gaps in clinical care in patients with chronic kidney disease (CKD) lead to poor outcomes. Objective. To compare the effectiveness of an ...

Electronic Health Record Portals and Patient-Centered ...

RPV is a system that allows patients with CKD access to test results and information about their health status and personal treatment. An ...

Electronic health records: a new tool to combat chronic kidney ...

Automated clinical alerts using EHRs may help to diagnose CKD earlier and improve referral rates. Recent reports from Canada, Australia and other developed ...

The CKD-DETECT Randomized Trial

New diagnoses of chronic kidney disease occurred in 1 (0.5%) patient in the alert and 2 (1.0%) in the control group (OR 0.50, 95%CI 0.04-5.53; P=0.570). There ...

Electronic Alerts for Acute Kidney Injury: Retrospective ...

Among 14 719 patients, 1304 had adverse outcomes. KDIGO-based e-alerts were fired in 2598 patients of whom 2554 also met AACC criteria, 1138 were detected by ...

Electronic health record alerts for acute kidney injury - PMC

The primary outcome occurred in 653 (21.3%) of 3059 patients with an alert and in 622 (20.9%) of 2971 patients receiving usual care (relative risk 1.02, 95% ...

Patient Electronic Health Record Portal Use and ...

We examined whether patient use of an electronic health record portal was associated with demographics or kidney function and whether portal use predicted ...

Leveraging EHR Data Can Help Aid in CKD Detection, ...

Using electronic health records (EHFRs) to create digital phenotyping may help close gaps in detecting and managing chronic kidney disease ...