A cloud-based digital health navigation program for colorectal cancer screening

基于云的结直肠癌筛查数字健康导航程序

• 批准号: 10697474
• 负责人: David P Miller
• 金额: $ 39.8万
• 依托单位: DIGITAL HEALTH NAVIGATION SOLUTIONS, LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10697474
• 关键词: Address; Adult; Advisory Committees; Age; American; COVID-19; Cancer Etiology; Caring; Cessation of life; Colonoscopy; Colorectal Cancer; Communities; Cost Analysis; Devices; Effectiveness; Electronics; Eligibility Determination; Ensure; Environment; Ethnic Population; Feces; Federally Qualified Health Center; Feedback; Focus Groups; Future; Goals; Health Technology; Health system; Healthcare Systems; Home; Knowledge; Learning; Medical; Modeling; Outcome; Patients; Phase; Population Heterogeneity; Preventive care; Preventive service; Publications; Race; Randomized, Controlled Trials; Reporting; Risk; Rural; Schedule; Site; Small Business Technology Transfer Research; Source; Stream; Subgroup; Tablets; Technology; Testing; Text; Text Messaging; Time; Training; United States; United States Preventative Services Task Force; Universities; Update; Visit; Work; accountable care organization; aged; barrier to care; cloud based; colorectal cancer screening; commercialization; cost; digital; digital health; effectiveness testing; empowerment; forest; health care service organization; health care settings; health disparity; innovation; medical schools; member; outreach; patient portal; pilot trial; primary care practice; primary outcome; programs; response; screening; screening guidelines; screening services; secondary analysis; uptake; usability; web app

Over 30% of age-eligible Americans fail to receive recommended screening for colorectal cancer (CRC), the second leading cause of cancer death in the United States. Multilevel barriers explain why so many Americans fail to receive routine CRC screening. Patients report a lack of knowledge about the need for screening or their screening options, and many view screening as messy, uncomfortable, or embarrassing. Busy clinicians report a lack of time to deliver preventive care, and many clinicians only discuss colonoscopy. Lastly, healthcare systems lack strategies to reach out to patients independent of a scheduled medical visit. Disruptions caused by COVID19 also have led to a decrease in the use of preventive services. To address these multilevel barriers, our team has developed and tested a tablet-based digital health navigator for colorectal cancer screening called mPATH™ (mobile Patient Technology for Health). mPATH™ determines if patients are due for CRC screening, educates them about their options, and lets them request a screening test directly via the program. In a randomized controlled trial conducted in primary care practices, mPATH™ doubled the proportion of patients who completed CRC screening and had excellent usability ratings. However, we have learned that our tablet-based model of mPATH™ is difficult to scale as it requires on-site training and changes to workflows. The goal of this Fast Track STTR proposal is to develop and test a cloud-based version of mPATH™ that patients can use at home independent of a scheduled medical visit. Patients will access mPATH™ on their own devices using a hyperlink sent via text message or patient portal. The cloud version of mPATH™ will have the proven effective content of the tablet version, including the ability to request a screening test directly via the program. mPATH™ will then share this information with the patient’s healthcare organization so screening can be arranged. This cloud-based version will be highly scalable, have broad reach, and be easy to support, making it a commercially viable product. To accomplish this goal, the work of this proposal will: (1) create a culturally appropriate and engaging cloud-based version of mPATH™ by leveraging input from community members, an expert Scientific Advisory Committee, and feedback from users; (2) determine the feasibility of the cloud-based mPATH™-CRC web app in a highly pragmatic pilot trial conducted in a large health system; (3) test the reach and effectiveness of the mPATH™ web app in two different healthcare settings: a large health system, and an Accountable Care Organization that includes rural Federally Qualified Health Centers; and (4) determine the value generated by mPATH™ in each healthcare setting. This Fast Track STTR will provide information that is critical to mPATH™’s future commercialization by demonstrating its reach into diverse populations, its effectiveness in increasing screening, and the value it generates to potential future customers. If successful, mPATH™ will fill a critical need for a commercially available, easily scalable solution for colorectal cancer screening and potentially other preventive services.

超过30％的年龄符合年龄的美国人未能接受建议的结直肠癌筛查（CRC），即 美国癌症死亡的第二大原因。多层障碍解释了为什么这么多美国人 无法接受常规的CRC筛查。患者报告缺乏有关筛查或他们的需求的知识 筛选选项，许多将筛选视为凌乱，不舒服或令人尴尬的筛查。忙碌的临床医生报告 缺乏提供预防性护理的时间，许多临床医生只讨论结肠镜检查。最后，医疗保健 系统缺乏与预定医疗访问无关的患者接触的策略。造成了干扰 到Covid19还导致预防服务的使用减少。解决这些多级 障碍，我们的团队已经开发并测试了基于平板电脑的大肠癌的数字健康导航器 筛选称为MPATH™（健康的移动患者技术）。 MPATH™确定患者是否到期 对于CRC筛查，请他们对他们的选择进行教育，并让他们直接通过 程序。在初级保健实践中进行的随机对照试验中，MPATH™将 完成CRC筛查并且具有出色可用性评级的患者比例。但是，我们有 了解到，我们基于平板电脑的MPATH™模型很难扩展，因为它需要现场培训和更改 工作流程。这个快速轨道sttr提案的目的是开发和测试基于云的版本的 患者可以独立于预定的医疗访问，患者可以在家中使用。患者将进入 MPATH™在自己的设备上使用通过短信或患者门户发送的超链接。云版本的 MPATH™将具有平板电脑版本的有效内容，包括请求 直接通过程序筛选测试。然后，MPATH™将与患者的医疗保健共享此信息 组织可以安排筛查。这个基于云的版本将具有很高的可扩展性，具有广泛的 到达，易于支撑，使其成为商业上可行的产品。为了实现这一目标， 该提案将：（1）创建一个文化适当且引人入胜的基于云的Mathe™。 利用社区成员，专家科学咨询委员会的意见以及用户的反馈； （2）在高度务实的试点试验中确定基于云的MPATH™-CRC Web应用程序的可行性 在大型卫生系统中进行； （3）在两个中测试MPATH™Web应用程序的覆盖范围和有效性 不同的医疗保健环境：一个大型卫生系统，以及包括农村在内的负责任组织 联邦资格卫生中心； （4）确定MPATH™在每个医疗保健中产生的价值 环境。这种快速轨道的sttr将提供对Math™未来商业化至关重要的信息 证明其进入潜水员人群，在增加筛查方面的有效性以及IT的价值 生成潜在的未来客户。如果成功，MPATH™将满足商业上的关键需求 可用的，易于扩展的结论直肠癌筛查和其他预防服务的解决方案。