Patient-Centered Informatics System to Enhance Health Care in Rural Communities

以患者为中心的信息系统，加强农村社区的医疗保健

• 批准号: 7692964
• 负责人: MATTHEW H SAMORE
• 金额: $ 40.06万
• 依托单位: UNIVERSITY OF UTAH
• 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/7692964
• 关键词: Patient; Centered; Informatics; System; Enhance

DESCRIPTION (provided by applicant): We propose a research demonstration project to evaluate whether integrating the functions of an electronic medical record, personal health record, and communication system leads to more patient-centered care in rural communities in the Intermountain West. This system, which we call the Unified Health Resource (UHR), combines the patient controlled personal health record with the ability to read and, if necessary, improve the accuracy of the information in the electronic medical record. The clinician, who controls information in the electronic medical record, can view and comment on the personal health record, when granted access by the patient. Structured e-visits support several types of electronic communications between clinicians, clinic staff, and patients. Clinics send a variety of automated reminders to patients, including structured electronic forms to solicit electronic reporting of possible symptoms of adverse drug events and to promote better organization of concerns prior to in-person visits. Patients request medication refills and report results of home monitoring tests, such as blood pressure readings and blood glucose values online. The system facilitates the reconciliation of clinician and patient medication lists. The proposal builds on our prior work to implement and evaluate health information technology in rural settings. Clinics that participated in our previous studies will be recruited to this new project. We will apply formative evaluation methods to assess and improve usability, usefulness, and adoption. To estimate impact on patient-centered care, patients will be recruited to a multi-community observational cohort study. Measures of patient activation, involvement in decision-making, self-management behaviors, medication management, and preventive practices will be obtained at baseline and serially during follow-up. During Year Three, we will launch a community-wide education campaign to enhance adoption of the UHR by increasing awareness of personal health records and the utility of asynchronous communication with clinicians. In summary, the UHR combines the functions of multiple electronic tools to bring patients enhanced control of their own health data, increased options for solving personal health issues, and improved access and continuity of clinical care, freed from constraints of time and location. This health information technology will support a new model of interaction between clinicians and patients, aiming to increase the patient-centeredness of care. Our implementation of an education campaign within a rural public health framework will help extend the benefits to underserved populations and to guide nationwide dissemination efforts.

描述（由申请人提供）：我们提出了一个研究演示项目，以评估整合电子病历，个人健康记录和沟通系统的功能是否会导致西部山区山区农村社区以患者为中心的护理。我们称之为统一健康资源（UHR）的系统将患者控制的个人健康记录与阅读能力相结合，并在必要时提高电子病历中信息的准确性。当患者允许使用时，可以控制电子病历中的信息的临床医生可以查看和评论个人健康记录。结构化的电子视野支持临床医生，诊所人员和患者之间的几种类型的电子通信。诊所向患者发送了各种自动提醒，包括结构化电子形式，以征集电子报告不良药物事件的可能症状，并在面对面就诊之前更好地组织关注点。患者要求补充药物并报告家庭监测测试的结果，例如血压读数和在线血糖值。该系统促进了临床医生和患者药物清单的和解。该提案基于我们先前的工作，以实施和评估农村环境中的健康信息技术。参加我们以前研究的诊所将被招募到这个新项目。我们将采用形成性评估方法来评估和提高可用性，实用性和采用。为了估计对以患者为中心的护理的影响，将招募患者进行多个共同点观察队列研究。将在基线和随访期间连续获得患者激活，参与决策，自我管理行为，药物管理和预防措施的措施。在第三年级，我们将通过提高对个人健康记录的认识以及与临床医生的异步沟通的实用性来发起一项社区范围内的教育运动，以增强UHR的采用。总而言之，UHR结合了多种电子工具的功能，使患者可以增强对自己的健康数据的控制，增加解决个人健康问题的选择，并提高了临床护理的访问和连续性，摆脱了时间和位置的限制。这种健康信息技术将支持临床医生和患者之间的相互作用的新模型，旨在增加患者以患者为中心的护理。我们在农村公共卫生框架内实施教育运动将有助于将收益扩展到服务不足的人群，并指导全国范围内的传播工作。

项目成果

Understanding adoption of a personal health record in rural health care clinics: revealing barriers and facilitators of adoption including attributions about potential patient portal users and self-reported characteristics of early adopting users.

了解农村医疗保健诊所采用个人健康记录：揭示采用的障碍和促进因素，包括潜在患者门户用户的归因和早期采用用户的自我报告特征。

• 发表时间: 2013
• 期刊: AMIA ... Annual Symposium proceedings. AMIA Symposium
• 作者: Butler,JorieM;Carter,Marjorie;Hayden,Candace;Gibson,Bryan;Weir,Charlene;Snow,Laverne;Morales,Jose;Smith,Anne;Bateman,Kim;Gundlapalli,AdiV;Samore,Matthew
• 通讯作者: Samore,Matthew