Empowering SCD Patients with Web Tools to Improve Care Communications

为 SCD 患者提供网络工具以改善护理沟通

• 批准号: 8318826
• 负责人: ALLEN Y. TIEN
• 金额: $ 12.05万
• 依托单位: MEDICAL DECISION LOGIC, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-15 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8318826
• 关键词: Abdominal colic; Accident and Emergency department; Acute; Address; Adherence; Admission activity; Analgesics; Area; Attitude; Back Pain; Behavior; Businesses; Caring; Case Management; Clinical; Collaborations; Communication; Computer software; Coupled; Data; Data Sources; Development; Disease; Disease Management; Economics; Emergency treatment; Empathy; Ensure; Evaluation; Generations; Goals; Growth; Health; Health Policy; Healthcare; Healthcare Systems; Hematology; Home environment; Hospitals; Human Resources; Individual; Instruction; Insurance; Internet; Intervention; Kidney; Knowledge; Location; Mails; Maryland; Medical; Medical History; Medical Records; Mental Health; Monitor; Online Systems; Outcome; Pain; Pain Measurement; Patient Care; Patients; Pharmaceutical Preparations; Phase; Policy Developments; Population; Primary Health Care; Process; Provider; Public Health; Registries; Research Infrastructure; Savings; Secure; Sickle Cell Anemia; Small Business Innovation Research Grant; Software Design; Staging; System; Systems Integration; Technology; Third-Party Payer; Transfusion; Translations; Uncertainty; Visit; base; community setting; comparative effectiveness; data registry; demographics; design; digital; effectiveness research; empowered; experience; health disparity; hospital admission rate; improved; innovation; interoperability; novel; payment; research study; software systems; tool

DESCRIPTION (provided by applicant): The pioneering and strategic goal of this SBIR project "Empowering SCD Patients with Web Tools to Improve Care Communications" is to create a specialized niche product that improves emergency department (ED) treatment of patients with sickle cell disease (SCD) presenting with a painful crisis, decreasing costly hospital admissions. At present, the unfortunate normative experience of these patients is grounded in ED staff lacking specific knowledge for titrating pain medication administration with quantitative pain assessment, coupled with inadequate medical record systems that often make it difficult to resolve uncertainty about a patient's identity and medical history, and too often, lack of in-depth medical understating of SCD and its treatment. The project will address these issues with an innovative combination of web technology and scientific and clinical knowledge to create a novel web-based Case Management Registry product ("webCMR"). webCMR will provide ED personnel with secure and unambiguous information about the patient's identity, using a digital photograph and demographics, information about the patient's Primary Care and Hematology Providers, type of sickle cell disease, transfusion complications, medications used at home, and medications recommended for emergency treatment of acute vaso-occlusion. WebCMR will provide clear instructions for titrating administration of pain medication based on repeated quantitative assessment of pain, communicating proven best practices to ED providers. It will automatically generate an e-mail message to the patient's Providers, informing them of the ED visit. Along with this direct intervention to improve the care of patients with SCD in the ED, technology innovations in webCMR will strengthen its utility and commercial value by addressing data communications to support scientific processes for public health, interoperability with other systems, and generalizability for broader application to other stages of SCD management and other disease areas. Phase I will include study of data communications in the form of a regional registry and data dashboard to be developed for use by the Maryland State Department of Health and Mental Hygiene (DHMH) to monitor ED visits at the population level. This registry is expected to have significant value to DHMH, helping to inform scientific policy development and monitor outcomes. In a similar way, it will be a useful data source for insurance companies about rates of hospital admissions that can serve to justify payment for use of webCMR, providing a business case for sustainability. Reducing hospital admission rates by 10 percent would generate savings to third party payers in MD of at least $5 million annually, an average of nearly $3,000 per patient per year. These economics provide an opportunity for business sustainability and growth. The creation of webCMR will be highly focused on engaging ED providers and SCD patients with the software design and implementation process, ensuring that the Case Management aspect of webCMR will be carefully adapted to the priority needs of both patients and providers. A key design goal is for webCMR to facilitate positive and systematic communications between patients and providers. Likewise, the Registry aspect of webCMR will be carefully adapted to the priority needs of public health officials. The evaluation of the product will address the potential burden of use for both patient and ED staff, and assess benefits in comparison to current practices.

描述（由申请人提供）：该 SBIR 项目“为 SCD 患者提供网络工具以改善护理沟通”的开创性和战略目标是创建一种专门的利基产品，以改善镰状细胞病患者的急诊科 (ED) 治疗（ SCD）呈现出痛苦的危机，减少了昂贵的住院费用。目前，这些患者不幸的规范经历是因为急诊室工作人员缺乏通过定量疼痛评估来滴定止痛药给药的具体知识，加上医疗记录系统不完善，往往难以解决患者身份和病史的不确定性，而且常常缺乏对 SCD 及其治疗的深入医学认识。该项目将通过网络技术与科学和临床知识的创新结合来解决这些问题，以创建一种新颖的基于网络的病例管理注册产品（“webCMR”）。 webCMR 将使用数码照片和人口统计数据向急诊室人员提供有关患者身份的安全且明确的信息、有关患者的初级保健和血液学提供者的信息、镰状细胞病的类型、输血并发症、家庭使用的药物以及推荐的药物急性血管闭塞的紧急治疗。 WebCMR 将根据对疼痛的重复定量评估，为滴定止痛药物的给药提供明确的说明，并向 ED 提供者传达经过验证的最佳实践。它将自动生成一封电子邮件发送给患者的提供者，通知他们急诊室就诊的情况。除了这种改善急诊室 SCD 患者护理的直接干预措施之外，webCMR 的技术创新还将通过解决数据通信问题来增强其实用性和商业价值，以支持公共卫生的科学流程、与其他系统的互操作性以及更广泛应用的普遍性到 SCD 管理的其他阶段和其他疾病领域。第一阶段将包括以区域登记和数据仪表板形式研究数据通信，供马里兰州健康和心理卫生部 (DHMH) 用于监测人口层面的急诊就诊。该注册表预计将对 DHMH 具有重大价值，有助于为科学政策制定提供信息并监测结果。同样，它将成为保险公司关于入院率的有用数据源，可以证明使用 webCMR 付费的合理性，并为可持续发展提供商业案例。将住院率降低 10% 每年将为医学博士的第三方付款人节省至少 500 万美元，平均每位患者每年节省近 3,000 美元。这些经济学为企业可持续发展和增长提供了机会。 webCMR 的创建将高度关注让 ED 提供者和 SCD 患者参与软件设计和实施过程，确保 webCMR 的病例管理方面将仔细适应患者和提供者的优先需求。 webCMR 的一个关键设计目标是促进患者和提供者之间积极、系统的沟通。同样，webCMR 的登记部分将根据公共卫生官员的优先需求进行仔细调整。该产品的评估将解决患者和急诊室工作人员的潜在使用负担，并评估与当前实践相比的好处。