Mobile Integrated Health in Heart Failure
The purpose of this study is to compare how two different types of care after a hospitalization reduce hospital readmissions and symptom burden. The two types of care are a Transitions of Care Coordinator and Mobile Integrated Health. In the Transitions of Care Coordinator group, participants will receive a phone call from a care coordinator right after they go home following a hospitalization to check in. In the Mobile Integrated Health group, participants will be offered access to a community paramedic in case they need medical care while they are recovering at home after a hospitalization. The community paramedic will come to their home to perform an evaluation and set up a visit with an emergency physician via video conference. They may receive treatment at home or be transported to the emergency department. The investigators will be compare how well a Transitions of Care Coordinator and Mobile Integrated Health reduce readmissions to the hospital within 30 days of discharge and improve patient-reported health-related quality of life. The investigators hypothesize that participants in the Mobile Integrated Health group will have fewer readmissions to the hospital within 30 days of discharge and better health-related quality of life compared to participants in the Transitions of Care Coordinator group.
Conditions:
🦠 Heart Failure
🗓️ Study Start (Actual) 4 January 2021
🗓️ Primary Completion (Estimated) 30 July 2025
✅ Study Completion (Estimated) 30 December 2025
👥 Enrollment (Estimated) 2100
🔬 Study Type INTERVENTIONAL
📊 Phase NA
Locations:
📍 New York, New York, United States
📍 New York, New York, United States
📍 New York, New York, United States

📋 Eligibility Criteria

Description

    Inclusion Criteria:

    • * Medicare or Medicaid recipient
    • * Current diagnosis of HF
    • * Receiving inpatient care at NewYork Presbyterian or Mount Sinai Health Systems
    • * Live in NYC

    Exclusion Criteria:

    • * Non-English, Spanish, Mandarin, or French speaking
    • * Diagnosis of dementia or psychosis
    • * Anticipated discharge to, or current residence in, skilled nursing facility or rehab center
    • * Anticipated discharge to, or currently receiving, hospice including home hospice
    • * Current candidate for and awaiting heart transplant
    • * Current left ventricular assist device (LVAD)
Ages Eligible for Study: 18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No

🗓️ Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

  • First Submitted 4 December 2020
  • First Submitted that Met QC Criteria 4 December 2020
  • First Posted 10 December 2020

Study Record Updates

  • Last Update Submitted that Met QC Criteria 15 February 2024
  • Last Update Posted 16 February 2024
  • Last Verified February 2024