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Targeted EHR-based Communication of Diagnostic Uncertainty in the ED

Sponsor: Thomas Jefferson University • ClinicalTrials.gov ID: NCT06638021

Registry updated: 2026-10-01

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Description

The goal of the clinical trial is to evaluate the preliminary effectiveness and the implementation feasibility of the Targeted EHR-based Communication about Uncertainty (TECU) strategy in improving the quality of care transitions from the emergency department (ED) to home. The overall specific aims related to the trial are to test the preliminary effectiveness of TECU compared to standard of care in reducing patient uncertainty and return ED visits and evaluate the adoption of TECU, exploring patient and clinician barriers and facilitators to TECU implementation.

Interventions

Targeted EHR-based Communication of Diagnostic Uncertainty (TECU) (Behavioral)
The Targeted EHR-based Communication about Uncertainty (TECU) strategy will be activated in the electronic health record (Epic) every time an ED clinician enters an uncertain diagnosis for a patient being discharged, and will notify the clinician to counsel the patient about uncertainty while additionally triggering automated 1) insertion and printing of the patient handout and 2) provision of a hyperlink for the clinician-facing checklist to guide the discharge conversation.

Eligibility criteria

Patient Inclusion Criteria: * age 18 years or older * English language speaking * assigned a symptom-based diagnosis in the EHR clinical impression * planned for discharge from the ED during the enrollment visit * able to complete follow up assessments in 2 and 30 days * TECU best practice advisory (BPA) electronic health record alert activates during their discharge process Patient Exclusion Criteria: * under the age of 18 years * non-English speaking * clinically unstable, psychologically impaired or intoxicated, or otherwise unable to provide informed consent as judged by research staff member * admitted to hospital * unable to complete follow up in 2 and 30 days * previously enrolled in this study (during a prior ED visit)

Conditions

Diagnostic Uncertainty

Locations

Thomas Jefferson University — Philadelphia, Pennsylvania, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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