eHealth Records to Improve Dental Care for Patients with Chronic Illnesses

电子健康记录可改善慢性病患者的牙科护理

• 批准号: 7672315
• 负责人: James Ryan Fricton
• 金额: $ 35.39万
• 依托单位: HEALTHPARTNERS INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7672315
• 关键词: eHealth; Records; Improve; Dental; Care

The primary goal of this proposal is to conduct a randomized clinical trial to evaluate the effectiveness of an integrated electronic health record system that includes a eMedical Record (EMR), eDental Record (EDR), and a Personal eHealth Record (PHR) to improve the quality and safety of dental care for patients with chronic illnesses. Chronic medical conditions such as diabetes, heart disease, pulmonary disease, and conditions that cause xerostomia (dry mouth) have a profound effect on the quality and safety of dental care if neglected. If these medical conditions are not identified and addressed in routine dental care, the quality and safety of the care is adversely affected. The emergence of EDRs in dental offices offers new opportunities for measurement and improvement of the quality and safety of care of by dentists. An EDR integrated with an EMR and PHR provides a unique opportunity to improve the dental care of patients with chronic conditions by both alerting patients to their special care requirements as well alerting dentists at the point of care. Furthermore, the integration of an EMR, PHR, and EDR into an integrated electronic health record system adds great potential for improved health information exchange, enhanced communication, and improved and cost effective care, particularly for patients with chronic illnesses. We propose a 3-arm, 2-year prospective, group-randomized clinical trial of 47 dentists in 17 clinics to evaluate the effectiveness of two interventions that utilize simple reminders within the integrated electronic health record. The study examines two interventions versus a usual care (UC) control. The interventions are designed to address how, and to whom, special dental care needs are communicated. The interventions are: 1) a reminder to patients delivered primarily via their PHRs through email or if email is not available through phone by the dental clinic staff and/or postal mail (Group A) or 2) a point-of-care reminder to the dentist within the EDR (Group B). These reminders reflect the special dental care needs of four chronic conditions: diabetes mellitus, congestive heart failure, chronic obstructive pulmonary disease, and xerostomia (dry mouth) as caused by medications or related conditions. This project demonstrates how leveraging an integrated electronic health record system can improve patient outcomes, increase awareness and improve clinical decision-making by identifying problems needing remediation and providing immediate evidence-based recommendations.

该提案的主要目的是进行一项随机临床试验，以评估 综合电子健康记录系统的有效性，其中包括 记录（EMR），Edental Record（EDR）和个人eHealth记录（PHR） 改善慢性病患者牙科护理的质量和安全性。慢性的 医疗状况，例如糖尿病，心脏病，肺部疾病和疾病 这会导致静脉（口干）对 牙齿护理是否被忽略。如果未确定这些医疗状况并解决 常规的牙科护理，护理的质量和安全受到不利影响。 EDR在牙科办公室的出现为测量和 改善牙医的护理质量和安全性。 EDR与 EMR和PHR提供了一个独特的机会，可以改善患者的牙科护理 两者都会提醒患者的特殊护理要求。 在护理点上警告牙医。此外，EMR，PHR和 EDR进入集成的电子健康记录系统，为改进的巨大潜力增加了 健康信息交流，增强的沟通以及改善和成本效益 护理，特别是对于患有慢性疾病的患者。 我们提出了47位牙医的3臂，2年的前瞻性群体随机试验 17个诊所评估使用简单提醒的两种干预措施的有效性 在集成的电子健康记录中。该研究检查了两种干预措施 与通常的护理（UC）控制。干预措施旨在解决如何以及 传达了谁，特殊的牙科护理需求。干预措施是：1） 提醒患者主要是通过电子邮件分娩的患者，或者如果不是电子邮件 通过牙科诊所工作人员和/或邮政邮件（A组）或2）通过电话获得 护理点提醒EDR内的牙医（B组）。这些提醒反映了 四种慢性疾病的特殊牙科护理需求：糖尿病，充血 心力衰竭，慢性阻塞性肺部疾病和静脉疾病（口干） 由药物或相关疾病引起。该项目展示了如何利用 集成的电子健康记录系统可以改善患者的预后，增加 通过确定需要的问题来意识并改善临床决策 修复并提供直接的基于证据的建议。