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Telehealth Education Leveraging Electronic Transitions Of Care for COPD Patients
Sponsor: University of Chicago
Summary
Transitions of Care (TOC) between hospital, ambulatory, and home settings for high-risk, frequently hospitalized adults with chronic diseases, such as chronic obstructive pulmonary disease (COPD) are complex, costly, and vulnerable to safety threats and poor health outcomes. One potential solution to address this gap in care is the Transitional Care Model (TCM), which utilizes a patient-centered approach with in-home interventions; since in-person in-home visits are costly, using innovative telehealth, such as virtual visits via teleconferencing may be just as effective with greater feasibility, scalability, and sustainability, particularly in the post-COVID-19 era as has been seen the rapid expansion of these technologies. With a transdisciplinary team of experts from cognitive science, care transitions/handoffs, human factors engineering, design, implementation science, and health services research, the study team proposes to implement and evaluate via a randomized clinical trial the "TELE-TOC: Telehealth Education: Leveraging Electronic Transitions Of Care for COPD patients," intervention which includes a virtual visit, pharmacy-based, in-home intervention for COPD patients to improve medication use and patient outcomes among a population at high risk for readmission and medication safety events.
Official title: TELE-TOC: Telehealth Education Leveraging Electronic Transitions Of Care for COPD Patients
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
218
Start Date
2025-02-19
Completion Date
2026-12-31
Last Updated
2026-01-14
Healthy Volunteers
No
Conditions
Interventions
Virtual at Home Medication Reconciliation Visit(s)
Patients will have their medications reviewed by the TELE-TOC interventionalist, a member of the pharmacy team (anticipated)
Virtual At Home Medication Education Visit(s)
Patients will be provided with inhaler education by the TELE-TOC interventionalist, a member of the pharmacy team (anticipated)
COPD advanced practice nurse Inpatient Consult
Patients will receive a COPD consult by an advanced practice nurse as part of standard of care
Inpatient Medication Reconciliation
Patients will have their medications reviewed by member(s) of the clinical care team as part of standard of care
Post-discharge nurse 48 hour phone follow-up call
Patients will receive a post-discharge nurse 48 hour phone follow-up call as part of standard of care
Post-discharge follow-up advanced practice nurse outpatient visit
Patients will be scheduled for a 1-2 week post-discharge visit with the COPD advanced practice nurse as part of standard of care
Locations (1)
University of Chicago
Chicago, Illinois, United States