Automated Youth-To-Adult Transition Planning Using Health Information Technology

利用健康信息技术自动制定青少年到成人过渡计划

基本信息

批准号：
9375613
负责人：
William Estus Bennett
金额：
$ 7.88万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9375613
关键词：
Academy Address Adherence Adolescence Adolescent Adoption Adult Age Algorithms American American College of Physicians Automation Award Behavior Caring Child Child health care Childhood Chronic Client satisfaction Clinic Clinical Clinical Decision Support Systems Communities Complex Computer software Computerized Medical Record Computers Custom Data Decision Support Systems Dimensions Disease Disease Outcome Elements Face Familiarity Family Family Physicians Feasibility Studies Funding Future Gastroenterology Gastrointestinal Diseases Goals Guidelines Health Health Personnel Healthcare Healthcare Systems Indiana Institute of Medicine (U.S.)Intervention Intervention Studies K-Series Research Career Programs Logic Logistics Medical Medical Records Methods Monitor Outcome Patient-Focused Outcomes Patients Pediatrics Pilot Projects Policies Preparation Primary Health Care Process Provider Questionnaires Readiness Reporting Responsible Person Services Side Standardization System Tablets Testing Time Training Transition Elements Translating Universities Visit Work Youth care systems computerized design disability experience health information technology improved medical schools post intervention primary care setting programs randomized trial satisfaction skills syntax tool young adult

项目摘要

This proposal seeks to improve transition care using health information technology. The process of transition from a pediatric to adult provider is a universal need across both primary care and subspecialties. Little work has been done specifically within pediatric gastroenterology to address the needs of patients with chronic gastrointestinal disease. We propose to use an existing computerized clinical decision support system (CHICA – the Child Health Improvement through Computer Automation system) to pilot a youth-to-adult Transition module within a large primary care network. This will be accomplished by automating the “Six Core Elements of Healthcare Transition” set forth by the National Health Care Transition Center. These core elements consist of: (1) sharing the transition policy with families, (2) providing transition tracking and monitoring, (3) assessing transition readiness using a standardized tool (the TRAQ – Transition Readiness Assessment Questionnaire), (4) transition planning through iterative preparation of all necessary transition skills and documents, (5) accomplishing the transfer of care itself, and (6) assessing transfer completion. Each of these core elements will be accomplished using a combination of patient-facing (tablets) and provider-facing (webforms alongside the electronic medical record). Once these software rules are written and tested, they will be piloted in the existing primary care decision support system. We will iteratively assess the following goals: (1) each patient’s transition readiness as appropriate for their age, and (2) provider and patient satisfaction with the transition process. These outcomes will be compared in a pre-post design, data will be collected during the first 6 months prior to the Transition module being implemented in CHICA. Following this 6-month period, the Transition module will be turned on, and a repeat assessment made of these outcomes. If this pilot test is successful, we will then be ready to launch this module in a similar system (CHICA-GI) that will be live in the pediatric gastroenterology clinic. Once this system has a transition module active, we will be able to test if it accomplishes similar goals for gastroenterology subspecialty patients, including disease-specific transition goals, in future R21 and R01 applications. Overall, the proposed R03 represents a stepwise set of activities which will expand upon the groundwork laid in my K-award application regarding the exploration of whether adherence to guidelines or recommended care practices can be improved through the use of computerized decision support systems, and thereby ultimately impact health and patient-centered outcomes. Given my past experience of implementing a primary care CDSS (K-award Aim 1) and my current experience implementing a gastroenterology-specific CDSS (K-award Aims 2 and 3), the R03 fits seamlessly with my current activities. This award will allow for another dimension to be added to the existing system on both the primary care and gastroenterology side.

该建议旨在使用健康信息技术改善过渡护理。过渡过程从小儿到成人提供者，在初级保健和亚专业中都是普遍的需求。很少的工作已在小儿胃肠病学中专门完成，以满足慢性患者的需求胃肠道疾病。我们建议使用现有的计算机化临床决策支持系统（CHICA） - 通过计算机自动化系统改善儿童健康），以实行青年到成年的过渡大型初级保健网络中的模块。这将通过自动化“六个核心元素国家医疗保健过渡中心提出的医疗保健转变。这些核心要素组成：（1）与家庭共享过渡政策，（2）提供过渡跟踪和监视，（3）评估使用标准化工具（TRAQ - 过渡准备评估问卷）的过渡准备就绪，（4）通过迭代准备所有必要的过渡技能和文件的过渡计划，（5）完成护理本身的转移，（6）评估转移完成。这些核心元素中的每一个将使用面向患者（平板电脑）和面向提供商的组合（WebForms）来完成电子病历）。一旦编写和测试了这些软件规则，它们将在现有的初级保健决策支持系统。我们将迭代评估以下目标：（1）每个患者的过渡准备就绪适合其年龄，以及（2）提供者和患者对过渡的满意过程。这些结果将在验证前设计中进行比较，将在前6个期间收集数据在Chica实施过渡模块之前的几个月。在这个六个月后，将打开过渡模块，并重复评估这些结果。如果此试点测试是成功，我们将准备在类似系统（CHICA-GI）中启动该模块，该模块将居住在小儿胃肠病学诊所。一旦该系统具有过渡模块活动，我们将能够测试是否实现了胃肠病学亚专业患者的类似目标，包括疾病特异性过渡目标，将来R21和R01应用程序。总体而言，拟议的R03代表一组逐步的活动这将扩大我的K-宣告申请中有关探索是否是否的基础。可以通过使用计算机化来遵守准则或建议的护理实践决策支持系统，从而最终影响健康和以患者为中心的结果。鉴于我的过去实施初级保健CDS（K-award AIM 1）和我目前实施A的经验胃肠病学特异性的CDS（k-award Aims 2和3），R03与我当前的活动无缝符合。该奖项将允许在初级保健和现有系统中添加另一个维度胃肠病学方面。