Empowering providers to improve care for disadvantaged patients: design and prototype testing of novel user interface for electronic health records

帮助医疗服务提供者改善对弱势患者的护理：电子健康记录新颖用户界面的设计和原型测试

• 批准号: 10401209
• 负责人: CHRISTOPHER KREIS
• 金额: $ 25.51万
• 依托单位: ASP.MD
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-13 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10401209
• 关键词: Acute; Address; Adoption; Artificial Intelligence; Caring; Chronic; Clinical; Clinical Data; Complex; Consumption; Data; Data Display; Diabetes Mellitus; Diagnosis; Diet; Dietary History; Disadvantaged; Electronic Health Record; Ensure; Environment; Exercise; Face; Future; Goals; Grant; Health; Health Personnel; Healthcare; Homelessness; Hypertension; Hypoglycemia; Insulin; Knowledge; Laboratories; Licensing; Machine Learning; Measures; Medicaid; Medical; Methods; Online Systems; Ophthalmology; Outcome; Patients; Pharmaceutical Preparations; Phase; Physicians; Population; Practice Management; Primary Health Care; Process; Production; Provider; Quality of Care; Reading; Resources; Risk; Role; Source; Specialist; Structure; Surveys; Symptoms; System; Technology; Testing; Time; TimeLine; Training; Underserved Population; United States; Vendor; Visit; Visual; Vulnerable Populations; Weight; Work; application programming interface; base; burnout; care providers; clinical decision support; clinically relevant; cloud based; cognitive load; commercialization; comorbidity; data quality; design; digital; disadvantaged population; disparity reduction; empowered; experience; foot; glucose monitor; health information technology; health practice; improved; innovation; interoperability; knee pain; longitudinal dataset; next generation; novel; point of care; preference; pressure; prototype; satisfaction; social; social health determinants; tool; trend; usability; user centered design

PROJECT SUMMARY There is an emerging digital divide in healthcare between those who care for disadvantaged patients and those who care for less vulnerable populations. In the past decade, electronic health record (EHR) adoption and use has increased but unequally. Providers caring for disadvantaged populations are less likely to have and use advanced EHRs with sophisticated clinical decision support, analytics, and other functionalities. While EHRs are failing to meet the needs of United States’ providers more generally, EHR-related challenges are particularly acute for providers who treat disadvantaged populations due to time pressures, limited resources, and the need to address many social issues. Furthermore, EHRs have resulted in the accumulation of vast amounts of data, but providers do not have time to sift through it all in a patient encounter – better tools are needed to summarize, organize, and display the data in a way that better supports care. For chronic conditions such as diabetes, providers need to instantly see, assess, and take action on their patients’ status in a glance, without searching through laboratory results, weights, diet, history, medications, notes, and comorbidities scattered throughout a system. ASP.MD and the RAND Corporation have developed preliminary designs for a more usable EHR user interface (UI) that organizes and consolidates clinical data into “Viewers” based on clinically meaningful problems. Viewers are far more advanced than traditional problem lists. They visualize context- relevant longitudinal data, set visit agendas, track tasks, and execute other clinically useful activities. These visual innovations help providers quickly assess a patient’s overall status and specific clinical needs based on their data and symptoms. In this work, we will engage providers who care for Medicaid and other disadvantaged populations to further develop and test this novel EHR UI. In Aim 1, we will use user-centered design methods to develop detailed prototypes and clinical scenarios for testing. The scenarios will be common for providers who treat disadvantaged populations and they will promote improvement on established quality measures. We will integrate these prototypes into an existing EHR, developed by ASP.MD. In Aim 2, we will test the usability of the prototypes through structured sessions. ASP.MD is an ideal setting for developing and testing this innovation by building off its existing, federally certified commercial EHR and practice management systems. ASP.MD’s EHR is web-based, making it possible to immediately distribute new features to all users. We will build using the standards-based fast health interoperability resource (FHIR) application programming interfaces (API), making it possible to use our Viewers with other EHRs as well. This work has the potential to substantially reduce disparities by giving providers who care for disadvantaged populations an affordable, advanced EHR. Providers will have access to relevant, organized, synthesized clinical data at the point of care, facilitating their ability to close quality of care gaps and reducing burnout. It also has the potential to greatly improve the quality of data in EHRs, which can enable further innovation.

项目概要 在医疗保健领域，照顾弱势患者的人与照顾弱势患者的人之间正在出现数字鸿沟。 在过去十年中，电子健康记录 (EHR) 的采用和使用有所增加，但 照顾弱势群体的提供者不太可能拥有和使用先进的电子病历。 而复杂的临床决策支持、分析和其他功能却无法满足患者的需求。 更广泛地说，美国的医疗服务提供者认为，与 EHR 相关的挑战对于接受治疗的医疗服务提供者来说尤其严峻。 由于时间压力、资源有限以及需要解决许多社会问题而导致弱势群体。 此外，电子病历导致了大量数据的积累，但提供者没有时间筛选 在与患者的接触中经历这一切——需要更好的工具来总结、组织和显示数据，以便 对于糖尿病等慢性疾病，提供者需要立即查看、评估并采取行动。 患者的状况一目了然，无需搜索实验室结果、体重、饮食、病史、药物、笔记、 ASP.MD 和兰德公司已经初步开发了分散在整个系统中的合并症。 设计一个更可用的 EHR 用户界面 (UI)，该界面将临床数据组织并整合到基于“查看器”的“查看器”中 具有临床意义的问题比传统的问题列表更先进。 相关纵向数据、设置访问议程、跟踪任务以及执行其他临床有用的活动。 创新帮助提供商根据患者的数据和数据快速评估患者的整体状况和具体临床需求 在这项工作中，我们将与医疗补助和其他弱势群体的医疗服务提供者合作，以进一步推动这一工作。 开发和测试这个新颖的 EHR UI 在目标 1 中，我们将使用以用户为中心的设计方法来开发详细的原型。 以及用于测试的临床场景，这些场景对于治疗弱势群体和的提供者来说是常见的。 他们将促进对既定质量措施的改进，我们将把这些原型整合到现有的质量措施中。 EHR，由 ASP.MD 开发。在目标 2 中，我们将通过结构化会话来测试原型的可用性。 通过构建现有的、联邦认证的商业 EHR 来开发和测试这项创新的理想环境 ASP.MD 的 EHR 是基于网络的，可以立即分发新的。 我们将使用基于标准的快速健康互操作性资源（FHIR）应用程序来构建。 编程接口（API），使得我们的查看器也可以与其他电子病历一起使用这项工作具有潜力。 为照顾弱势群体的提供者提供负担得起的先进服务，从而大幅减少差距 电子病历提供者将可以在护理点获取相关的、有组织的、综合的临床数据，从而促进他们的工作。 它还有可能大大提高数据质量。 电子病历，这可以实现进一步的创新。