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% 的符合年龄条件的美国人未能接受建议的结直肠癌 (CRC) 筛查， 美国癌症死亡的第二大原因 多层次的障碍解释了为什么有如此多的美国人。 未能接受常规 CRC 筛查的患者表示缺乏筛查必要性或其自身知识。 筛查选项，许多人认为筛查是混乱、不舒服或忙碌的居民报告。 缺乏时间提供预防性护理，许多参议员只讨论结肠镜检查最后，医疗保健。 系统缺乏独立于预定医疗就诊而接触患者的策略。 新冠肺炎疫情也导致预防性服务的使用减少。 为了克服障碍，我们的团队开发并测试了基于平板电脑的结直肠癌数字健康导航器 名为 mPATH™（移动患者健康技术）的筛查可确定患者是否到期。 CRC 筛查，向他们介绍他们的选择，并让他们直接通过 在初级保健实践中进行的一项随机对照试验中，mPATH™ 将这一结果提高了一倍。 完成 CRC 筛查并具有出色可用性评级的患者比例。 了解到我们基于平板电脑的 mPATH™ 模型难以扩展，因为它需要现场培训和更改 此快速通道 STTR 提案的目标是开发和测试基于云的版本。 患者可以在家使用 mPATH™，而无需进行预定的医疗访问。 mPATH™ 在他们自己的设备上使用通过短信或患者门户发送的超链接 的云版本。 mPATH™ 将拥有平板电脑版本经过验证的有效内容，包括请求 然后，mPATH™ 会直接通过该程序与患者的医疗保健人员共享此信息。 组织因此可以安排筛选。这个基于云的版本将具有高度可扩展性，具有广泛的用途。 达到并易于支持，使其成为商业上可行的产品，需要付出努力。 该提案将：(1) 创建一个文化上合适且有吸引力的基于云的 mPATH™ 版本 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 (3) 分两次测试 mPATH™ Web 应用程序的覆盖范围和有效性 不同的医疗保健环境：大型卫生系统和责任医疗组织，其中包括农村地区 联邦合格的健康中心；以及 (4) 确定 mPATH™ 在每个医疗保健中产生的价值 该快速通道 STTR 将提供对 mPATH™ 未来商业化至关重要的信息。 展示其对不同人群的影响、增加筛查的有效性及其价值 如果成功，mPATH™ 将满足商业化的关键需求。 用于结直肠癌筛查和其他潜在预防服务的可用且易于扩展的解决方案。