Understanding the Impact of Health Information Exchange-Enabled Care Plans to Coordinate Care among High-Need, High-Cost Patients

了解健康信息交换支持的护理计划对协调高需求、高成本患者护理的影响

• 批准号: 10488602
• 负责人: Ashok Reddy
• 金额: $ 2.7万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10488602
• 关键词: Understanding; Impact; Health; Information; Exchange

PROJECT SUMMARY/ABSTRACT: High-need, high-cost patients (HNHC) often experience poor coordination of care, a key driver of increased cost and utilization. Healthcare organizations and policymakers are investing in care coordination mechanisms that combine health information exchange with individualized care plans to fix the fragmented care HNHC patients receive, but evidence for these approaches is limited. In 2012, the Washington State Health Care Authority (HCA), which oversees the state Medicaid program, implemented a health information exchange (HIE) across all hospitals referred to as the Emergency Department Information Exchange. As part of HIE implementation, HCA provides financial incentives to hospitals to develop individualized care plans to improve care coordination for Emergency Department (ED) high utilizers (≥ 5 ED visits per year). The current project seeks to apply advanced quantitative methods in causal inference, comparative effectiveness, and qualitative methods to understand gaps in our knowledge in the use of HIE-enabled care plans to improve care coordination for HNHC patients. To accomplish this research, I will link an existing Washington State Medicaid dataset to patients who received a care plan in EDIE. Working under the mentorship of experts in health service research, I will: (1) measure the impact of HIE-supported care plans on healthcare utilization among HNHC patients (2) identify subgroups of HNHC patients with lower ED healthcare utilization after receipt of a care plan (3) describe the implementation of HIE-care plans and content of care plans in HNHC patients. These studies will inform healthcare systems on ways to improve care coordination for complex patient populations. This work will also help me establish a set of skills to become an independent investigator addressing the gaps in care coordination for HNHC populations.

项目摘要/摘要： 高需求、高费用的患者 (HNHC) 经常会遇到护理协调不力的情况，这是一个关键驱动因素 医疗保健组织和政策制定者正在投资增加的成本和利用率。 将健康信息交换与个体化相结合的护理协调机制 护理计划旨在解决 HNHC 患者接受的分散护理问题，但这些证据 2012 年，华盛顿州医疗保健管理局 (HCA) 采取了有限的措施。 监督州医疗补助计划，在整个州实施健康信息交换 (HIE) 所有医院都称为急诊科信息交换 作为 HIE 的一部分。 实施后，HCA 向医院提供经济激励，以发展个性化护理 计划改善急诊科 (ED) 高利用率人员（≥ 5 次 ED 就诊）的护理协调 每年）当前的项目寻求在因果关系中应用先进的定量方法。 推理、比较有效性和定性方法来了解我们的差距 使用支持 HIE 的护理计划来改善 HNHC 护理协调的知识 为了完成这项研究，我将链接现有的华盛顿州医疗补助数据集。 在 EDIE 接受护理计划的患者在健康专家的指导下工作。 服务研究，我将：(1) 衡量 HIE 支持的护理计划对医疗保健的影响 HNHC 患者的利用率 (2) 确定 ED 较低的 HNHC 患者亚组 收到护理计划后的医疗保健利用 (3) 描述 HIE 护理的实施 HNHC 患者的护理计划和内容这些研究将为医疗保健系统提供信息。 这项工作也将有助于改善复杂患者群体的护理协调。 我建立了一套技能，成为一名独立调查员，解决护理方面的差距 HNHC 人群的协调。