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Framing for Electronic Health Records

Overseen ByRyan Raimi, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas at Dallas

Disqualifiers: No portal access, No EHR check

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 aims to determine how different messages influence individuals to check their electronic health records (EHRs) and report any mistakes. It tests whether messages emphasizing positive or negative outcomes increase the likelihood of record review. Participants will receive various types of messages or none at all, then check their EHRs for errors. This trial suits individuals who have accessed their patient portal and reviewed their EHRs in the past year. As an unphased trial, it offers a unique opportunity to contribute to enhancing patient communication and healthcare accuracy.

Do I need to stop my current medications for this trial?

The trial does not specify whether you need to stop taking your current medications, but it seems unlikely since the study focuses on reviewing electronic health records.

What prior data suggests that this method of framing messages is safe for patients?

Previous studies have shown that electronic health records (EHRs) make healthcare safer by reducing errors like medication mistakes and infections. Research also indicates that EHRs improve communication among healthcare providers, leading to fewer medical errors and a safer system for patients.

This trial examines how different messages might influence how people review their EHRs. The focus is on communication, not a drug or medical procedure. The trial is labeled "Not Applicable" in terms of phases, indicating fewer safety concerns compared to medical trials. Participants will safely review their health records and answer surveys.¹ ² ³ ⁴ ⁵

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different ways of framing messages can encourage patients to review their Electronic Health Records (EHRs) for potential errors. Unlike traditional approaches that may not emphasize patient engagement, this trial uses psychological framing techniques to motivate action. By testing various message styles—like focusing on personal health risks or the well-being of loved ones—researchers aim to identify which approach most effectively prompts patients to identify and report errors in their EHRs. This could lead to better health outcomes by increasing patient involvement and reducing preventable mistakes in medical records.

What evidence suggests that this trial's treatments could be effective for improving patient engagement with electronic health records?

This trial will compare different ways of framing messages to encourage participants to review their electronic health records (EHRs). Studies have shown that the presentation of information can greatly influence people's actions. In this trial, some participants will receive messages emphasizing the risks of not checking their EHRs, such as potential errors leading to severe health consequences. Other participants will receive messages highlighting the benefits of reviewing EHRs, such as acting as their own best advocate and improving health outcomes. Both methods aim to encourage people to spot and report any errors, ultimately enhancing overall health.⁶ ⁷ ⁸ ⁹ ¹⁰

Who Is on the Research Team?

Ryan Raimi, PhD

Principal Investigator

The University of Texas at Dallas

Are You a Good Fit for This Trial?

This trial is for individuals who use electronic health records (EHRs). Participants should be willing to review their EHRs and answer surveys about their experience. There are no specific inclusion or exclusion criteria provided, suggesting the study may be open to a broad range of EHR users.

Inclusion Criteria

Subjects should have access to their patient portal

Subjects should have checked their EHR in the past 12 months

Exclusion Criteria

Not having access to their patient portal

Not having checked their EHR in the past 12 months

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Initial Survey

Participants complete a short survey about trust, distrust, and privacy concerns

5 minutes

1 visit (online)

EHR Review

Participants log into their patient portal and review their EHRs

10 minutes

1 visit (online)

Final Survey

Participants complete a survey about their healthcare provider, patient portals, EHR errors, and demographic information

5 minutes

1 visit (online)

Follow-up

Participants are monitored for their engagement in EHR error discovery and reporting

1 week

What Are the Treatments Tested in This Trial?

Interventions

Framing

Trial Overview The study tests how different ways of presenting messages about errors in EHRs affect patient engagement. It looks at whether emphasizing positive or negative outcomes influences patients' willingness to review and report errors in their own EHRs.

How Is the Trial Designed?

13Treatment groups

Active Control

Group I: Loss Framing x Egocentric x "Errors"Active Control1 Intervention

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential error in your EHR."

Group II: Gain Framing x Egocentric x "Errors"Active Control1 Intervention

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. This is a great opportunity to act as your own best advocate, check your EHRs to identify any potential errors, and improve your health outcomes."

Group III: Gain Framing x Allocentric x "Errors"Active Control1 Intervention

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Such errors can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential errors. Your loved ones will thank you for prioritizing your safety."

Group IV: Control groupActive Control1 Intervention

The participants in this arm will not receive any message, encouraging them to review their EHRs and report any potential errors.

Group V: Loss Framing x Allocentric x "Errors"Active Control1 Intervention

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Such errors can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential error in your EHR. Your loved ones will thank you for prioritizing your safety."

Group VI: Gain Framing x Egocentric x "Unintended Mistakes"Active Control1 Intervention

Group VII: Loss Framing x Egocentric x "Unintended Mistakes"Active Control1 Intervention

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential unintended mistake in your EHR."

Group VIII: Gain Framing x Allocentric x "Unintended Mistakes"Active Control1 Intervention

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Such unintended mistakes can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential unintended mistakes. Your loved ones will thank you for prioritizing your safety."

Group IX: Loss Framing x Allocentric x "Unintended Mistakes"Active Control1 Intervention

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Such unintended mistakes can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential unintended mistake in your EHR. Your loved ones will thank you for prioritizing your safety."

Group X: Loss Framing x Egocentric x "Inaccuracies"Active Control1 Intervention

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an e inaccuracy in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential inaccuracy in your EHR."

Group XI: Gain Framing x Egocentric x "Inaccuracies"Active Control1 Intervention

Group XII: Gain Framing x Allocentric x "Inaccuracies"Active Control1 Intervention

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an inaccuracy in your EHR. Such inaccuracies can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential inaccuracies. Your loved ones will thank you for prioritizing your safety."

Group XIII: Loss Framing x Allocentric x "Inaccuracies"Active Control1 Intervention

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an inaccuracy in your EHR. Such inaccuracies can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential inaccuracy in your EHR. Your loved ones will thank you for prioritizing your safety."

Find a Clinic Near You

Who Is Running the Clinical Trial?

The University of Texas at Dallas

Lead Sponsor

Trials

Recruited

108,000+

Virginia Polytechnic Institute and State University

Collaborator

Trials

162

Recruited

26,900+

University of Pennsylvania

Collaborator

Trials

2,118

Recruited

45,270,000+

Citations

1.pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov/articles/PMC8902175/

A Qualitative Analysis of the Impact of Electronic Health ...This study aims to explore the lived experiences of clinicians, to assess the role of EHR in improving the quality and safety of healthcare.

2.clinicaltrials.govclinicaltrials.gov/study/NCT07206550

Study Details | NCT07206550 | The Role of Framing and ...The first goal of our research is to understand the effects of different wordings of certain messages on patients' engagement in reviewing their electronic ...

3.sciencedirect.comsciencedirect.com/science/article/pii/S2352914823002198

Use of electronic medical records in the digital healthcare ...The frequency of EMR use is higher and attitudes towards EMR are more favorable among physicians than among nurses. EMR use is effective in the communication ...

4.medrxiv.orgmedrxiv.org/content/10.1101/2024.10.08.24315097v4

Enhancing Uploads of Health Data in the Electronic ...Results The results show that a PFS has a positive effect on uploading (OR 4.276, P=.015). Although there was no effect regarding the length of ...

5.park.edupark.edu/blog/digital-health-records-improving-efficiency-and-patient-care/

Digital Health Records: Improving Efficiency and Patient CareThis access to complete patient histories helps reduce the likelihood of medical errors, such as prescribing incorrect medications or dosages.

6.pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov/articles/PMC11618012/

The Impact of Patient Access to Electronic Health Records on ...The primary goal of EHRs is to improve the efficiency, quality, and safety of patient care regimen by facilitating accurate and timely access to ...

7.bmcmedinformdecismak.biomedcentral.combmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-016-0299-y

The impact of electronic records on patient safety: a qualitative ...The study adds to an emerging but limited evidence base that has reported potential negative impacts of electronic systems upon patient safety.

8.tandfonline.comtandfonline.com/doi/full/10.1080/19932820.2024.2421625

Impact of Implementing Electronic Nursing Records on ...Studies have confirmed that EHRs improve patient safety by reducing medication errors, falls, and infections. They have also enhanced data ...

9.jamanetwork.comjamanetwork.com/journals/jamanetworkopen/fullarticle/2770283

Association of Electronic Health Record Use Above ...Association of Electronic Health Record Use Above Meaningful Use Thresholds With Hospital Quality and Safety Outcomes.

10.iosrjournals.orgiosrjournals.org/iosr-jnhs/papers/vol14-issue4/Ser-3/A1404030113.pdf

The Impact of Electronic Health Records on Patient Safety ...Better care coordination and fewer medical mistakes are two additional benefits of EHRs that aid communication among healthcare practitioners.

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Framing for Electronic Health Records

What You Need to Know Before You Apply

Who Is on the Research Team?

Are You a Good Fit for This Trial?

Timeline for a Trial Participant

What Are the Treatments Tested in This Trial?

Find a Clinic Near You

Who Is Running the Clinical Trial?

Citations

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