Development of a cloud-based, self-report SUD intake system enabling primary care clinicians to routinely complete, implement, document, and bill for biopsychosocial assessments for the underserved

开发基于云的自我报告 SUD 摄入系统，使初级保健临床医生能够定期为服务不足的人群完成、实施、记录生物心理社会评估并开具账单

• 批准号: 10469898
• 负责人: BENJAMIN B BRODEY
• 金额: $ 25.61万
• 依托单位: TELESAGE, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469898
• 关键词: Address; Affect; Attention; Behavior; Caring; Cellular Phone; Chronic; Client; Clinic; Clinical; Code; Complement; Complex; Computer software; Cost Analysis; Custom; DSM-V; Development; Devices; Diagnosis; Diagnostic; Documentation; Drug usage; Evaluation; Family; Feedback; Goals; Gold; Health Insurance Portability and Accountability Act; Health Personnel; Health Professional; Incentives; Individual; Insurance; Intake; Intuition; Life Style; Link; Medicaid; Medical; Medicare; Mental disorders; Modeling; Nature; Occupational; Patient Self-Report; Patients; Persons; Phase; PhenX Toolkit; Primary Health Care; Privatization; Process; Protocols documentation; Provider; Reading; Recommendation; Recording of previous events; Reporting; Resources; Running; Social support; Software Tools; Speech; Substance Use Disorder; Symptoms; System; Tablets; Testing; Text; Time; Training; Underserved Population; Visual impairment; Vulnerable Populations; Work; Writing; base; behavioral health; biopsychosocial; cloud based; cost; cost effective; design; diagnostic platform; digital; dual diagnosis; fifth grade; flexibility; health care availability; health care delivery; help-seeking behavior; literacy; mHealth; medical specialties; mental state; personalized diagnostics; personalized medicine; prevent; provider behavior; response; screening; self help; social; software development; standard care; support tools; symposium; tool; treatment guidelines; treatment planning; user-friendly; willingness

Project Summary The US healthcare delivery system suffers from intractable problems that increasingly prevent it from identifying and treating people suffering from SUDs. Primary care clinicians, the front line of our health care delivery system, have neither adequate tools nor incentives to evaluate SUDs and co-occurring mental health disorders. The result is chronic under-diagnosis and under-treatment, in addition to the associated adverse personal and societal impacts. These shortcomings disproportionately affect individuals from underserved populations who already have poor access to health care resources. We propose to develop and test a new Primary Care-SUD-Intake System (P-SUD-IS) that is intended to address the problem of under-diagnosis by changing primary care clinician behavior and motivating clients with previously undiagnosed SUDs to seek help. The P-SUD-IS will be a HIPAA-compliant, user-friendly, automated, and cloud-based system, and, if successful, will reduce the time needed for primary care clinicians to complete and bill for a biopsychosocial assessment. The P-SUD-IS will assess and record family SUD history, personal SUD history, educational history, occupational history, social history, current social supports, and willingness to participate in treatment. Diagnosis and a mental status exam will be conducted using TeleSage’s existing validated DSM-5 self-report diagnostic system (SAGE), which will be integrated into the new P-SUD-IS. Responses to all questions will be used to provide clinicians with detailed electronic reports that can be entered into the client’s EHR. This system is in no way intended to replace the clinician. As a decision-support tool, the P-SUD-IS is intended to help clinicians without specialized training in behavioral health and SUDs use all available resources to complete a biopsychosocial assessment. This study will assess whether underserved primary care clients might be willing and able to complete the P-SUD-IS. Questions will be written at a 5th grade reading level and read aloud using a native text-to- speech application. The client will receive a highly customized electronic report with educational & self-help information as well as links to relevant on-line referral systems. The P-SUD Intake System will generate a report containing actionable information that will make it easier for primary care clinicians to determine if a referral is warranted, and for them to provide the referral documentation that will be most helpful. The new strategy needs to fit within the normal workflow of primary care clinics so as not to cause disruptions. Our goal is for the clinician to be able to look at the report for 2-3 minutes, ask the client specific questions informed by the report, discuss options with the client, finalize the treatment plan, write orders, and bill a sufficient amount for a biopsychosocial assessment to make the whole process economically feasible. By making primary care SUD assessments cost effective and feasible, the P- SUD-IS will have a large impact on the underserved and undiagnosed.

项目摘要 美国的医疗保健提供系统遭受了棘手的问题，越来越防止它 识别和对待患有泡沫的人。初级保健临床医生，我们的医疗保健的前线 交付系统，既没有适当的工具，也没有激励措施来评估泡沫和同时发生的心理健康 疾病。结果是慢性诊断和治疗不足，除了相关的不良 个人和社会影响。这些缺点不成比例地影响了服务不足的人 已经无法获得医疗保健资源的人群。 我们建议开发和测试一种旨在的新的初级护理系统（P-SUD-IS） 通过改变初级保健临床行为并激励客户，解决诊断不足的问题 有了以前未诊断的肥皂水寻求帮助。 P-SUD-IS将是符合HIPAA的，用户友好的， 自动化和基于云的系统，如果成功，将减少初级保健临床医生所需的时间 完成生物心理社会评估的费用。 P-SUD-IS将评估和记录家庭SUD 历史，个人SUD历史，教育历史，占领历史，社会历史，当前的社会支持， 并愿意参加治疗。诊断和心理状态检查将使用 TELESAGE现有的经过验证的DSM-5自我报告诊断系统（SAGE），将集成到 新的p-sud-is。对所有问题的回答将用于为临床医生提供详细的电子报告 可以将其输入客户的EHR。该系统绝不旨在取代临床。作为 决策支持工具，P-SUD-IS旨在帮助临床医生，而无需专门的行为培训 健康和SUDS使用所有可用的资源来完成生物心理社会评估。 这项研究将评估服务不足的初级保健客户是否愿意并且能够完成 p-sud-is。问题将以五年级的阅读水平编写，并使用本地文本到 - 语音申请。客户将通过教育和自助力获得高度定制的电子报告 信息以及指向相关的在线推荐系统的链接。 P-SUD进气系统将生成一个包含可行信息的报告，该报告将使更容易 初级保健临床医生确定是否需要转介，并向他们提供推荐 文档将最有帮助。新策略需要适合主要的主要工作流程 护理诊所，以免引起干扰。我们的目标是使临床能够查看2-3的报告 分钟，询问报告所告知的客户特定问题，与客户讨论选项，最终确定 治疗计划，写命令和账单足以进行生物心理社会评估，以使整体 过程在经济上可行。通过使初级保健SUD评估具有成本效益和可行性，p- SUD-IS将对服务不足和未诊断的人产生很大的影响。