Enhancing Complex Care through an Integrated Care Coordination Information System

通过综合护理协调信息系统加强复杂护理

基本信息

批准号：
7925573
负责人：
DAVID A. DORR
金额：
$ 40.32万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-30 至 2012-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7925573
关键词：
Enhancing Complex Care through Integrated

项目摘要

DESCRIPTION (provided by the applicant): Patients with chronic illness are at risk for complications and unnecessary disease exacerbations from a lack of coordination and quality in an already fragmented health care system. Many models of care management, like Care Management Plus (CMP), have been successful in improving health outcomes through clinical redesign using health information technology (HIT). To improve care for patients with complex needs these models use population management, patient-centered goals, quality measures, and clinical reminders. There are three objectives for proposed study. 1) To understand if an integrated care coordination information system (ICCIS) can be created in a diverse set of clinics using certified EHRs and existing standards. 2) To assess if the functions in the ICCIS system can be used by the clinics. 3) To evaluate if these system changes lead to improved patient outcomes. First, the research team will assess existing HIT capabilities of participating sites. Based on the initial assessment ICCIS will be implemented to see if HIT use in care of patients with complex healthcare needs is possible. Next, the implementation process and its perceived benefits will be assessed using the Glasgow REAIM model. REAIM is designed for measuring success at individual, programmatic, organizational, and policy levels. A randomized controlled trial will examine whether six participating clinics can use HIT to monitor and deliver care for high risk patients with a care coordination model (arm 1) or quality performance model (arm 2). Two outcome measures will be examined. 1) Change in utilization - hospitalizations and ED visits and 2) Patient satisfaction at the clinic level. Utilization will be examined by comparing hospitalization rates and ED visits before and after implementation using billing data. Patient satisfaction will be assessed by surveying a random sample of 1200 patients pre- and post-intervention. Research personnel will administer the ACAHPS survey with specific additional questions about transitions of care and care coordination.

描述（由申请人提供）：由于本已支离破碎的医疗保健系统缺乏协调和质量，慢性病患者面临并发症和不必要的疾病恶化的风险。许多护理管理模式，例如护理管理升级版 (CMP)，已经通过使用健康信息技术 (HIT) 进行临床重新设计，成功地改善了健康结果。为了改善对具有复杂需求的患者的护理，这些模型使用人口管理、以患者为中心的目标、质量措施和临床提醒。拟议的研究有三个目标。 1) 了解是否可以使用经过认证的 EHR 和现有标准在不同的诊所中创建综合护理协调信息系统 (ICCIS)。 2) 评估ICCIS系统的功能是否可供诊所使用。 3) 评估这些系统变化是否会改善患者的治疗效果。首先，研究团队将评估参与站点现有的 HIT 能力。根据初步评估，将实施 ICCIS，看看是否可以使用 HIT 来护理具有复杂医疗需求的患者。接下来，将使用格拉斯哥 REAIM 模型评估实施过程及其感知效益。 REAIM 旨在衡量个人、计划、组织和政策层面的成功。一项随机对照试验将检查六家参与诊所是否可以使用 HIT 通过护理协调模型（第 1 组）或质量绩效模型（第 2 组）来监测和为高风险患者提供护理。将审查两项成果衡量标准。 1) 使用情况的变化 - 住院和急诊就诊，以及 2) 诊所层面的患者满意度。将通过使用计费数据比较实施前后的住院率和急诊就诊率来检查利用率。将通过在干预前后随机调查 1200 名患者样本来评估患者满意度。研究人员将管理 ACAHPS 调查，并提出有关护理过渡和护理协调的具体附加问题。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Effect of a Pragmatic, Cluster-randomized Controlled Trial on Patient Experience With Care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.

务实的整群随机对照试验对患者护理体验的影响：通过医疗之家评估和重新设计（TOPMED）研究改变患者的结果。

DOI：
发表时间：
2016-08
期刊：
影响因子：
3
作者：
Dorr, David A;Anastas, Tracy;Ramsey, Katrina;Wagner, Jesse;Sachdeva, Bhavaya;Michaels, LeAnn;Fagnan, Lyle J
通讯作者：
Fagnan, Lyle J

A multi-perspective analysis of lessons learned from building an Integrated Care Coordination Information System (ICCIS).

对建立综合护理协调信息系统（ICCIS）的经验教训进行多角度分析。