Scalable Clinical Decision Support for Individualized Cancer Risk Management

个性化癌症风险管理的可扩展临床决策支持

• 批准号: 10215413
• 负责人: GUILHERME DEL FIOL
• 金额: $ 74.92万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10215413
• 关键词: Address; Adoption; Algorithms; Architecture; Breast Cancer Detection; Breast Cancer Risk Factor; Certification; Colorectal Cancer; Computer software; Coupled; Data; Data Reporting; Detection; Documentation; Ecosystem; Electronic Health Record; Environment; Family; Goals; Guidelines; Healthcare; Healthcare Systems; Incentives; Individual; Informatics; Information Retrieval; Infrastructure; Institutes; Institution; International; Intervention; Logic; Malignant Neoplasms; Modality; National Comprehensive Cancer Network; Natural Language Processing pipeline; Patient Care; Patients; Population; Primary Health Care; Process; Provider; PubMed; Recording of previous events; Research; Risk; Risk Assessment; Risk Management; Scanning; Screening for cancer; System; Technology; Testing; Universities; Utah; base; cancer risk; cancer type; care providers; clinical decision support; colorectal cancer risk; community clinic; design; experience; genetic counselor; health care service organization; healthcare community; high risk; improved; incentive program; malignant breast neoplasm; online course; online resource; open source; patient population; personalized screening; primary care setting; programs; risk stratification; screening; screening guidelines; support tools; symposium; web services

Project Summary / Abstract We propose to enable a scalable clinical decision support (CDS) platform that helps clinicians and patients select cancer screening strategies that are best suited to each individual. This kind of CDS is important because increased evidence supports personalizing cancer screening decisions according to each individual's unique cancer risks. While a highly desired goal, individualizing screening at a population scale requires the implementation of patient-specific risk assessments for several types of cancer. This is quite challenging in today's overwhelmed primary care environment. Our proposed CDS platform addresses this challenge by (i) automating the risk stratification process at the population level based on EHR data and patient reported data; (ii) prioritizing patients for case review by genetic counselors; and (iii) automatically communicating risk and screening recommendations with primary care providers and their patients. We will integrate the CDS platform with the Epic EHR and test it at the University of Utah Health Care community clinics and the Huntsman Cancer Institute. We will assess the generalizability of the CDS platform with a different EHR (Cerner) at a different institution (Intermountain Healthcare). To maximize the dissemination potential for the proposed cancer risk screening platform, we will extend two well-established open source CDS platforms: OpenCDS and OpenInfobutton. These platforms are reference implementations of international EHR standards that are required for EHR certification in the US. We will also obtain software certification from the Open Source EHR Alliance, share the CDS platform and our experiences with other awardees in the ITCR Program, present the CDS platform at national and international cancer and informatics conferences; and engage with relevant stakeholders through a technical expert panel. Any healthcare organization with a certified EHR will be able to use the proposed CDS platform. Therefore, if successful, this proposal can have a significant impact on disseminating individualized cancer screening practices according to the best available evidence.

项目摘要 /摘要 我们建议启用可扩展的临床决策支持（CD）平台，以帮助临床医生和患者 选择最适合每个人的癌症筛查策略。这种CD很重要 因为越来越多的证据支持个性化癌症筛查决策 独特的癌症风险。虽然一个高度期望的目标，但在人口量表上进行个性化筛查需要 对几种类型癌症的患者特定风险评估的实施。这很具有挑战性 今天不知所措的初级保健环境。我们提出的CD平台通过（i）解决了这一挑战 根据EHR数据和患者报告的数据在人群级别自动化风险分层过程； （ii）遗传辅导员优先考虑患者的病例审查； （iii）自动传达风险和 与初级保健提供者及其患者筛查建议。 我们将将CDS平台与EPIC EHR集成，并在犹他大学卫生保健中进行测试 社区诊所和亨斯曼癌症研究所。我们将评估CDS平台的推广性 在另一家机构（Intermountain Healthcare）中有不同的EHR（Cerner）。最大化 拟议的癌症风险筛查平台的传播潜力，我们将延长两个公认的 开源CDS平台：OpenCD和OpenInfobutton。这些平台是参考实现 美国EHR认证所需的国际EHR标准。我们还将获得软件 开源EHR联盟的认证，共享CDS平台以及我们与其他的经验 ITCR计划中的获奖者，在国家和国际癌症和信息学上介绍CDS平台 会议；并通过技术专家小组与相关的利益相关者互动。 任何拥有经过认证的EHR的医疗保健组织都将能够使用拟议的CDS平台。因此，如果 成功，该提案可能会对传播个性化的癌症筛查产生重大影响 根据最佳证据进行练习。