HealthyNCT02611999
Paid Price Information on Image and Procedure Ordering Rates
A study testing Single median price information and Paired inside/outside price information in people with Healthy, run by Boston Children's Hospital at 1 site in United States.
Trial summary
The investigators' study seeks to explore the impact of price information on physicians' ordering behavior and care quality. The investigators will evaluate the impact of the physician price transparency initiative at Atrius Health (ATRIUS) on rate of overall procedure and test orders, clinically inappropriate orders… Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Healthy
- What is being tested?
- Single median price information and Paired inside/outside price information
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,205 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2014to Oct 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Providers who can place orders in the EMR independently and who have worked at ATRIUS since 2013.
Who cannot join
- Providers who do not use the common electronic medical record system, cannot place orders in the electronic medical record independently (e.g., registered nurses, licensed practical nurses, registered dieticians), worked after hours Telecom, or were per diem.
Trial locations and contacts
1 site in 1 country.
United States1 site
Boston Children's Hospital
Boston, Massachusetts, 02115
About this study
Official title: The Effect of Paid Price Information on Image and Procedure Ordering Rates
The investigators' study seeks to explore the impact of price information on physicians' ordering behavior and care quality. The investigators will evaluate the impact of the physician price transparency initiative at Atrius Health (ATRIUS) on rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders. Ultimately, this study will help stakeholders understand the degree to which price information can help improve the value of healthcare.
Read the detailed description
The investigators' study team worked with Atrius Health (ATRIUS) to design a physician price transparency (PPT) intervention aimed at providing primary and specialty care physicians with price information on commonly-ordered outpatient procedures (e.g., Pap smears, ECHOs, colonoscopies) and imaging tests (e.g., CTs and MRIs). The 2014 PPT intervention was built upon a pilot that ATRIUS conducted in 2010. Starting January 1, 2014, ATRIUS randomized its physicians to 3 different study arms, those receiving:
- No price display for common outpatient procedures or imaging tests,
- A single price for each procedure or test, or
- A pair of prices for each procedure or test (that allowed physicians to compare prices that would be charged if the test was conducted at a facility within the ATRIUS network versus outside of it).
The mode for delivering this PPT intervention was ATRIUS' common electronic medical record (EMR), which all of its physicians use to place all orders related to outpatient procedures and imaging studies.
The investigators used a blocked randomized-controlled study design to quantitatively and qualitatively evaluate the effect of No, Single and Paired procedure and imaging test price information on: rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders.
The investigators used ATRIUS' administrative and EMR Data Repository to assess the quantitative outcomes proposed within this study. This repository contains the information the investigators need to block randomize at the practice level and to describe practices (e.g., size, location) and physicians (e.g., age, gender, specialty). It also captures all of the actions that physicians take when caring for patients (all orders are placed through their common EMR) and collects all of the information needed to assess clinical care quality using Healthcare Effectiveness Data and Information Set (HEDIS) measures. Data from this system have been used in numerous prior analyses of healthcare quality.
- Conditions
- Healthy
- Being tested
- Single median price information, Paired inside/outside price information
- Keywords
- Physicians' ordering behavior with price information
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Single median price informationBehavioural
Physicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo.
Paired inside/outside price informationBehavioural
Physicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo.
| Study group | Role | What they receive |
|---|---|---|
| Control | No intervention | Physicians in this Arm received only a paper memo with a list of common imaging tests and procedures. |
| Single Price | Experimental | Physicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo. Receives: Behavioral: Single median price information |
| Paired Inside/Outside Prices | Experimental | Physicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo. Receives: Behavioral: Paired inside/outside price information |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall procedure and imaging test ordering rate
Measured: 1 year
Choosing Wisely-based clinically inappropriate ordering rate
Measured: 1 year
HEDIS-based clinically appropriate ordering rate
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Nov 2015 (estimated)
- Study startJan 2014
- Primary completionDec 2014
- Study completionOct 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for HealthyStudies of the same condition, open and under way.
- More trials run by Boston Children's HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Investigator
- Enrolment
- 1,205 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boston Children's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Robert Wood Johnson Foundation, Atrius Health
- Responsible party
- Principal investigator, Alyna Chien, Boston Children's Hospital
- Investigators
- Alyna T Chien, MD, MS, Principal investigator, Assistant Professor of Pediatrics, Department of General Pediatrics, Division of Medicine, Boston Children's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02611999
- Sponsor's protocol ID
- P00011096
- Status last verified
- Jan 2017
- First submitted
- 19 Nov 2015
- Last updated
- 31 Jan 2017
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 31 Jan 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Paid Price Information on Image and Procedure Ordering Rates
- ClinicalTrials.gov ID
- NCT02611999
- Acronym / sponsor ID
- P00011096
- Conditions
- Healthy
- Keywords
- Physicians' ordering behavior with price information
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,205 participants (actual)
- Lead sponsor
- Boston Children's HospitalUniversity, hospital or other
- Collaborators
- Robert Wood Johnson Foundation, Atrius Health
- Study start
- Jan 2014
- Primary completion
- Dec 2014 (actual)
- Study completion
- Oct 2016 (actual)
- First posted
- 23 Nov 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators' study seeks to explore the impact of price information on physicians' ordering behavior and care quality. The investigators will evaluate the impact of the physician price transparency initiative at Atrius Health (ATRIUS) on rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders. Ultimately, this study will help stakeholders understand the degree to which price information can help improve the value of healthcare.
Detailed description
The investigators' study team worked with Atrius Health (ATRIUS) to design a physician price transparency (PPT) intervention aimed at providing primary and specialty care physicians with price information on commonly-ordered outpatient procedures (e.g., Pap smears, ECHOs, colonoscopies) and imaging tests (e.g., CTs and MRIs). The 2014 PPT intervention was built upon a pilot that ATRIUS conducted in 2010. Starting January 1, 2014, ATRIUS randomized its physicians to 3 different study arms, those receiving:
- No price display for common outpatient procedures or imaging tests,
- A single price for each procedure or test, or
- A pair of prices for each procedure or test (that allowed physicians to compare prices that would be charged if the test was conducted at a facility within the ATRIUS network versus outside of it).
The mode for delivering this PPT intervention was ATRIUS' common electronic medical record (EMR), which all of its physicians use to place all orders related to outpatient procedures and imaging studies.
The investigators used a blocked randomized-controlled study design to quantitatively and qualitatively evaluate the effect of No, Single and Paired procedure and imaging test price information on: rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders.
The investigators used ATRIUS' administrative and EMR Data Repository to assess the quantitative outcomes proposed within this study. This repository contains the information the investigators need to block randomize at the practice level and to describe practices (e.g., size, location) and physicians (e.g., age, gender, specialty). It also captures all of the actions that physicians take when caring for patients (all orders are placed through their common EMR) and collects all of the information needed to assess clinical care quality using Healthcare Effectiveness Data and Information Set (HEDIS) measures. Data from this system have been used in numerous prior analyses of healthcare quality.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Control | No intervention | –Physicians in this Arm received only a paper memo with a list of common imaging tests and procedures. |
| Single Price | Experimental | Behavioral: Single median price informationPhysicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo. |
| Paired Inside/Outside Prices | Experimental | Behavioral: Paired inside/outside price informationPhysicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Providers who can place orders in the EMR independently and who have worked at ATRIUS since 2013.
Key exclusion criteria (1 listed)
- Providers who do not use the common electronic medical record system, cannot place orders in the electronic medical record independently (e.g., registered nurses, licensed practical nurses, registered dieticians), worked after hours Telecom, or were per diem.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Single median price informationPhysicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo. | Behavioural | Single Price |
| Paired inside/outside price informationPhysicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo. | Behavioural | Paired Inside/Outside Prices |
Primary outcome
Overall procedure and imaging test ordering rate
Time frame: 1 year
Choosing Wisely-based clinically inappropriate ordering rate
Time frame: 1 year
HEDIS-based clinically appropriate ordering rate
Time frame: 1 year
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Jan 2017.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alyna T Chien, MD, MS principal investigator
Assistant Professor of Pediatrics, Department of General Pediatrics, Division of Medicine, Boston Children's Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Single median price information and Paired inside/outside price information in people with Healthy, run by Boston Children's Hospital at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall procedure and imaging test ordering rate (time frame: 1 year). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jan 2017.