Development and evaluation of patient medical summary from health information exchange to improve dental care

通过健康信息交换开发和评估患者医疗摘要以改善牙科护理

基本信息

批准号：
10344183
负责人：
Thankam P Thyvalikakath
金额：
$ 56.59万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10344183
关键词：
Address Adverse event Affect Architecture COVID-19 pandemic Caring Chronic Disease Clinical Communication Communities Community Health Consult Custom Dental Dental Care Dental General Practice Dental Group Practice Dental Hygienists Dental Records Dental Schools Dentistry Dentists Development Disease Electronic Health Record Evaluation Fast Healthcare Interoperability Resources Focus Groups Foundations Goals Health Indiana Interview Medical Medical History Medicine Methods Oral Oral health Outcome Patient Care Patients Pharmaceutical Preparations Physicians Physicians&apos Offices Population Preventive Protocols documentation Provider Questionnaires Recording of previous events Reporting Research Design Risk Scanning Service delivery model Specialist Study Subject System Time Update Vaccination Vendor base care coordination care costs care delivery design disease transmission effectiveness evaluation health care delivery health care service organization health management improved informant information organization innovation patient population patient safety population health practice setting prevent primary outcome prototype response screening success technology development usability user centered design

项目摘要

Project Summary To avoid potential harm and improve dental treatment success, dental clinicians (DCs) must obtain an up-to- date medical and medication history of their patients. Recent studies have reported discrepancies with patient- reported medical histories in electronic dental records (EDRs), and inconsistencies in physicians’ responses to DCs’ medical consults leading to delayed dental care. Large healthcare organizations (HCO) such as dental schools and health management organizations implemented integrated medical-dental electronic health record (EHR) (integrated EHR-EDR) to improve communication and referral between medical and dental professionals. However, deploying such systems alone will not resolve the current barriers because the relevant patient-specific information may be fragmented across different HCOs, stored in various EHR sections. Besides, most dental professionals are not credentialed with HCOs to have access to an integrated EHR-EDR system. The emergence of community and vendor-supported health information exchanges (HIEs) and the development of technologies and standards to exchange and display pertinent information is an opportunity for DCs to establish an integrated care delivery model regardless of their practice setting. The long-term goal is to improve communication and referrals between dental clinicians and medical professionals to improve patient care and promote screening and preventive management of chronic diseases. This proposal aims to develop and evaluate a usable patient medical summary (PMS) imported from the state- wide community Indiana Health Information Exchange (IHIE) that updates a dental clinician about their patients’ medical history and can be used even in solo- and small group dental practice settings. The central hypothesis is that the PMS will have a higher percentage of complete and up-to-date medical information, which will reduce the average time required to assess a dental patient case and determined by DCs to be clinically useful. The three specific aims are: 1) Validate the relevance and timeliness of information items that contribute to the PMS to assess a patients’ medical status; 2) develop prototypes that integrate the PMS with an EDR through user-centered design methods; 3) evaluate the effectiveness and efficiency of the PMS with general and specialist dentists. The two primary outcomes are a Fast Healthcare Interoperability Resources (FHIR)-based PMS application and a reconfigured Consolidated Clinical Document Architecture (C-CDA) that reduce dental clinicians’ reliance on patients and physicians’ office for information and reduce patients’ burden to share information with DCs. The proposed study will lay the foundation for an interprofessional dental- medical care delivery that enhances dental and overall care among the US population, promotes preventive management, and reduces dental care costs.

项目摘要为了避免潜在的伤害并改善牙科治疗成功，牙科临床医生（DC）必须获得最新的日期的医疗和药物病史。最近的研究报道了患者的差异报告了电子牙科记录（EDRS）中的病史，以及医生对 DCS的医疗咨询导致牙齿护理延迟。大型医疗组织（HCO），例如牙科学校和健康管理组织实施了综合医疗电子健康记录（EHR）（集成的EHR-EDR），以改善医疗和牙科之间的沟通和转诊专业人士。但是，仅部署此类系统将无法解决当前的障碍，因为相关的患者特异性信息可能会在不同的HCO上分散，并存储在各种EHR中部分。此外，大多数牙科专业人员都没有获得HCO的认证，可以访问综合的 EHR-EDR系统。社区和供应商支持的健康信息交流（HIE）的出现而且，交换和显示相关信息的技术和标准的发展是 DC的机会有机会建立综合护理交付模型，而不管其实践设置如何。长期目标是改善牙科临床医生与医疗之间的交流和推荐专业人士改善患者护理并促进对慢性疾病的筛查和预防治疗。该建议旨在开发和评估从国家进口的可用患者医疗摘要（PMS）广泛的社区印第安纳州健康信息交流（IHIE），该信息更新了牙科临床患者的病史，即使在单身和小组牙科练习环境中也可以使用。中央假设是，PMS的完整和最新医疗信息将具有更高的百分比这将减少评估牙科患者病例所需的平均时间，并由DC确定为临床上有用。三个具体目的是：1）验证信息项的相关性和及时性有助于评估患者的医疗状况的PMS； 2）开发将PM与通过以用户为中心的设计方法的EDR； 3）评估PMS的有效性和效率一般牙医。这两个主要结果是快速的医疗保健互操作性资源（FHIR）基于基于的PMS应用程序和重新配置的合并临床文档体系结构（C-CDA）减少牙科临床医生对患者和医师办公室的救济，以获取信息并减少患者的伯恩与DCS共享信息。拟议的研究将为跨专业牙科奠定基础 - 增强美国人口中牙齿和整体护理的医疗服务，促进预防性管理并降低牙科护理成本。