Testing health information technology tools to facilitate health insurance support: A protocol for an effectiveness-implementation hybrid randomized trial

Jennifer E. DeVoe, Nathalie Huguet, Sonja Likumahuwa-Ackman, Heather Angier, Christine Nelson, Miguel Marino, Deborah Cohen, Aleksandra Sumic, Megan Hoopes, Rose L. Harding, Marla Dearing, Rachel Gold

Research output: Contribution to journalArticle

4 Scopus citations


Background: Patients with gaps in health insurance coverage often defer or forgo cancer prevention services. These delays in cancer detection and diagnoses lead to higher rates of morbidity and mortality and increased costs. Recent advances in health information technology (HIT) create new opportunities to enhance insurance support services that reduce coverage gaps through automated processes applied in healthcare settings. This study will assess the implementation of insurance support HIT tools and their effectiveness at improving patients' insurance coverage continuity and cancer screening rates. Methods/design: This study uses a hybrid cluster-randomized design-a combined effectiveness and implementation trial-in community health centers (CHCs) in the USA. Eligible CHC clinic sites will be randomly assigned to one of two groups in the trial's implementation component: tools + basic training (Arm I) and tools + enhanced training + facilitation (Arm II). A propensity score-matched control group of clinics will be selected to assess the tools' effectiveness. Quantitative analyses of the tools' impact will use electronic health record and Medicaid data to assess effectiveness. Qualitative data will be collected to evaluate the implementation process, understand how the HIT tools are being used, and identify facilitators and barriers to their implementation and use. Discussion: This study will test the effectiveness of HIT tools to enhance insurance support in CHCs and will compare strategies for facilitating their implementation in "real-world" practice settings. Findings will inform further development and, if indicated, more widespread implementation of insurance support HIT tools. Trial registration: Clinical trial NTC02355262

Original languageEnglish (US)
Article number123
JournalImplementation Science
Issue number1
StatePublished - Aug 25 2015



  • Cancer screening
  • Health information technology
  • Health insurance
  • Hybrid design
  • Medicaid
  • Primary care

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics
  • Public Health, Environmental and Occupational Health

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