ROAMM-EHR: Pilot Trial of a Real-Time Symptom Surveillance System for Post-Discharge Surgical Patients

ROAMM-EHR：出院后手术患者实时症状监测系统的试点试验

• 批准号: 10451981
• 负责人: Todd Manini
• 金额: $ 22.88万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451981
• 关键词: Accelerometer; Behavioral; Caring; Clinical; Clinical Trials; Collaborations; Communities; Community Integration; Data; Data Analytics; Devices; Early Intervention; Ecological momentary assessment; Elderly; Electronic Health Record; Elements; Eligibility Determination; Evaluation; Evidence Based Medicine; Fatigue; Foundations; Future; Gait; Global Positioning System; Goals; Health; Health Care Costs; Health Personnel; Healthcare; Human; Human Resources; Intervention; Knowledge; Masks; Measures; Medical; Mission; Mobile Health Application; Modeling; Monitor; Moods; Nature; Operative Surgical Procedures; Orthopedic Surgery; Outcome; Outcome Measure; Outcome Study; Outcomes Research; Pain; Participant; Patient Care; Patient Monitoring; Patient Self-Report; Patient-Focused Outcomes; Patients; Pattern; Pharmaceutical Preparations; Physical Function; Physicians; Pilot Projects; Preparation; Private Sector; Process; Process Measure; Provider; Public Health; Public Sector; Qualitative Research; Quality of life; Randomized; Randomized Clinical Trials; Recovery; Rehabilitation therapy; Replacement Arthroplasty; Reporting; Research; Research Design; Research Personnel; Safety; Scheme; Social Functioning; Standardization; Symptoms; System; Technology; Testing; Time; TimeLine; Training; United States National Institutes of Health; Walking; advanced disease; age group; comparison group; data visualization; disease diagnosis; efficacy evaluation; evidence base; experience; healing; health data; high reward; high risk; high risk population; improved; indexing; innovation; mHealth; older patient; opioid use; patient portal; pilot trial; prescription opioid; prevent; quality assurance; recruit; retention rate; sensor; smart watch; standard of care; surgery outcome; symptom management; symptomatic improvement; tool; usability; wearable device; wound healing

Project Summary In recent years, mobile health (mHealth) apps have promised improved monitoring of health conditions to improve clinical outcomes. While existing sensors and devices collect relevant information from patients, such information is rarely shared with healthcare providers, potentially preventing timely interventions. Existing patient portals are typically static in nature— they lack remote and real-time capabilities for monitoring symptoms, medication use, activity levels and community mobility. These is vital information for understanding how patients recover from surgical procedures— this is particularly true for older adults who are highly vulnerable to poor recovery. The objectives of this application are to: 1) implement our existing Real-Time and Online Assessment and Mobility Monitor (ROAMM) smartwatch app platform into the electronic health record (EHR) to form the ROAMM-EHR platform and 2) test its feasibility in a pilot randomized clinical trial (RCT) in older patients (n= 50, >60 yrs) discharged after orthopedic surgery in preparation for a definitive trial. The central hypothesis is that integrating patient generated health data with the EHR system will improve symptom management and carry over into better outcomes, e.g. mobility function, lower pain, and better quality of life indices compared to the standard of care. The rationale is that ecological momentary assessment of patient symptoms can promote earlier and more informed micro-interventions such as changing medications, enhancing rehabilitation or performing more check-ins, resulting in improved patient outcomes. The pilot RCT will accomplish operational aims to refine and establish several elements for the future trial, including: the onboarding and behavioral approaches for using ROAMM-EHR, randomization scheme, study outcomes, quality assurance and standardization, recruitment and retention rates, data analytic strategies, technical implementation, and patient and staff usability/acceptability. The approach is innovative, because study will represent the first effort to not only build and implement but also to formally test a real-time post-surgical symptom surveillance platform by integrating patient generated health data from wearable devices with the EHR system. The proposed research is significant since timely post-surgical recovery will prevent both long- and short-term poor outcomes in older adults. The expected outcomes are 1) a new smart watch enabled symptom surveillance platform that will facilitate post-surgical care management and 2) the necessary knowledge for planning a definitive trial to reduce the major gap of evidence-based medicine for mHealth interventions. At its completion, the implementation and rigorous evaluation of ROAMM-EHR will not only test a transformative clinical tool, it will serve as a foundation for others in both public and private sectors who strive to capitalize on the promise of mHealth apps in healthcare.

项目摘要 近年来，移动健康（MHealth）应用程序已承诺改善对健康状况的监测 改善临床结果，而现有传感器和设备收集患者的相关信息 信息很少与医疗保健提供者共享，从而有可能阻止及时干预。 患者门户通常是静态的 - 他们缺乏监视的遥远和实时的倾向 症状，药物使用，活动水平和社区流动性。 患者如何从外科手术程序中恢复过来 - 这特别是真实的福特成年人 容易恢复不良的目标是：1） 在线评估和移动监控器（ROAMM）智能手表应用程序平台进入电子健康记录 （EHR）形成ROAMM-EHR平台并2）在飞行员随机临床（RCT）中测试它 骨科手术后，老年患者（n = 50年，> 60年）取消了准备进行的试验 中心假设是，将患者产生的健康数据与EHR系统整合在一起将改善症状 管理并结束更好的结果，例如移动性功能，较低的疼痛 与护理标准相比，指数是对通气的生态瞬时评估 症状可以促进较早，更明智的微型干扰，例如改变药物， 增强康复或进行更多检查，从而改善了PATCOM 将实现运营目标，以完善和建立未来审判的几个要素，包括： 使用ROAMM-EHR，随机方案，研究结果的入职和行为方法， 质量保证和标准化，招聘和保留率，数据分析策略，技术 实施，患者和员工的可用性/可接受性。 代表了不在第一个构建和iment上的第一个努力，而是正式测试实时外科手术 症状监视平台通过将可穿戴设备的患者生成的健康数据与它们整合在一起 EHR系统。 老年人的短期结果是1）启用了新的智能手表 症状监视平台将促进后手术后护理管理和2）必要的 规划最终试验的知识，以减少MHealth的循证医学差距 干预措施。 变革性的临床工具，它将成为努力的公共和私营部门其他部门的基础 利用医疗保健中MHealth应用程序的承诺。