Patient Entered Data for Clinical Decision Support to Personalize Pediatric Asthma Management

患者输入数据用于临床决策支持，以个性化小儿哮喘管理

• 批准号: 10631941
• 负责人: Mindy K Ross
• 金额: $ 19.6万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10631941
• 关键词: 11 year old; Address; Adherence; Algorithms; Area; Asthma; Award; Caregivers; Caring; Child; Childhood; Childhood Asthma; Clinic Visits; Clinical; Clinical Data; Clinical Decision Support Systems; Clinical Informatics; Clinical Trials; Complex; Data; Data Reporting; Decision Making; Development; Education; Electronic Health Record; Elements; Environment; Environmental Risk Factor; Family; Funding; Future; General Practitioners; Goals; Grant; Guidelines; Health Services; Health system; Healthcare; Hospitalization; Individual; Informatics; Information Technology; Knowledge; Manuals; Measures; Mentorship; Methods; Morbidity - disease rate; Outcome; Outpatients; Parents; Patient Care; Patient Outcomes Assessments; Patients; Pediatrics; Pharmaceutical Preparations; Pharmacotherapy; Phase; Physicians; Prevention program; Process; Productivity; Proxy; Psychosocial Factor; Publishing; Pulmonology; Qualitative Methods; Qualitative Research; Questionnaires; Recommendation; Reporting; Research; Risk Factors; Severities; Social Environment; Socioeconomic Status; Specialist; Standardization; Symptoms; System; Target Populations; Testing; Time; Training; United States National Institutes of Health; Visit; Work; Writing; age group; asthma exacerbation; asthmatic patient; career; clinical decision support; clinical decision-making; comorbidity; computerized; data integration; design; experience; implementation science; improved; informatics tool; information gathering; innovation; insight; low socioeconomic status; medication compliance; meetings; patient portal; pediatrician; point of care; professor; skills; stressor; support tools; tool; treatment as usual; uptake; usability; user-friendly

PROJECT SUMMARY/ABSTRACT This K23, Patient Entered Data for Clinical Decision Support to Personalize Pediatric Asthma Management, aims to improve asthma management through enhanced, automated implementation of pediatric asthma guidelines. The immediate goal is to gain skills and further training to understand methods to deliver effective clinical infor- matics tools for asthma management. The candidate is an Assistant Professor of Pediatrics in the Division of Pediatric Pulmonology at UCLA and a clinical informaticist. The candidate has assembled a nationally recog- nized and experienced mentorship team to provide guidance and expertise in qualitative research, data integra- tion, and implementation science. The training plan combines directed coursework to strengthen skills in these areas; and tutorials with qualitative and health service implementation experts to gain the requisite insight and hands-on experience needed for this project. Career training includes professional development seminars, key scientific meetings, and coursework on grant writing to optimize future independent research funding. The proposed research addresses the challenge practitioners have – and are currently unable to meet – to incorporate the complex National Asthma Education and Prevention Program (NAEPP) asthma guideline ele- ments in their asthma management plan. This study leverages patient entered data (via a patient portal) to create a comprehensive, automatically generated guideline-adherent clinical decision support (CDS) tool. In combina- tion with this patient-collected data, the CDS tool will use information from the individual’s electronic health record (EHR) to recommend a pediatric asthma management plan to the healthcare practitioner at the point of care. Critically, this study advances asthma management in the EHR by incorporating patient-reported data into the information gathering workflow. Previous use of patient portals in decision-making has had low uptake, partially due to usability issues and clinical workflow integration. Existing clinical decision support systems are often of narrow scope and do not incorporate the entirety of guideline elements, including psychosocial and environmen- tal factors. As such, the specific aims for this research are: 1) to develop and iteratively refine a user-friendly patient portal interface and evaluate its ability to capture key elements of the NAEPP guideline; 2) to develop a comprehensive CDS tool that integrates patient entered data; and 3) to pilot the CDS tool’s ability to capture guideline elements in the clinical setting. By understanding qualitative and user experience design during the development phases, we plan to launch a CDS tool that integrates seamlessly into end user tasks (both patient and practitioner), helping practitioners execute a comprehensive asthma management plan for children in the outpatient setting. An R01 application, planned to be submitted in Year 4 of this award, will evaluate the impact of this patient portal/CDS tool using an RCT design.

项目概要/摘要 该 K23（患者输入数据用于临床决策支持以个性化小儿哮喘管理）旨在 通过加强、自动化实施儿科哮喘指南来改善哮喘管理。 近期目标是获得技能和进一步培训，以了解提供有效临床信息的方法 - 该候选人是儿科助理教授。 加州大学洛杉矶分校的儿科肺病学和临床信息学家已经组建了全国认可的专家。 标准化且经验丰富的导师团队在定性研究、数据集成方面提供指导和专业知识 培训计划结合了定向课程，以加强这些方面的技能。 领域；以及与质量和卫生服务实施专家一起进行的教程，以获得必要的见解和 该项目所需的实践经验包括职业发展研讨会、关键。 科学会议以及拨款写作课程，以优化未来的独立研究经费。 拟议的研究解决了从业者面临的挑战——目前无法应对—— 纳入复杂的国家哮喘教育和预防计划 (NAEPP) 哮喘指南元素 这项研究利用患者输入的数据（通过患者门户）来创建。 综合的、自动生成的、符合指南的临床决策支持 (CDS) 工具。 结合患者收集的数据，CDS 工具将使用个人电子健康记录中的信息 (EHR) 在护理时向医疗保健从业者推荐小儿哮喘管理计划。 至关重要的是，这项研究通过将患者报告的数据纳入 EHR 中的哮喘管理 以前在决策过程中使用患者门户的信息收集工作流程的使用率较低。 由于可用性问题和临床工作流程集成，现有的临床决策支持系统通常是不同的。 范围狭窄，没有纳入全部指南要素，包括社会心理和环境因素 因此，本研究的具体目标是：1）开发和迭代完善用户友好的系统。 患者门户界面并评估其捕获 NAEPP 指南关键要素的能力 2) 制定一个 集成患者输入数据的综合 CDS 工具；以及 3) 试验 CDS 工具捕获的能力 通过了解临床环境中的定性和用户体验设计。 在开发阶段，我们计划推出一个 CDS 工具，该工具可以无缝集成到最终用户任务中（无论是患者还是患者） 和治疗师），帮助治疗师为儿童执行全面的哮喘管理计划 计划在该奖项的第 4 年提交的 R01 申请将评估其影响。 该患者门户/CDS 工具使用 RCT 设计。

项目成果

Partnered decision support: Parental perspectives of completing a pre-visit pediatric asthma questionnaire via the patient portal.

• DOI: 10.1002/ppul.25735
• 发表时间: 2022-01
• 期刊: Pediatric pulmonology
• 影响因子: 3.1
• 作者: Ross MK;Friedman S;Radparvar I;Ryan G
• 通讯作者: Ryan G

Adverse Childhood Experiences and Association With Pediatric Asthma Severity in the 2016-2017 National Survey of Children's Health.

• DOI: 10.1016/j.acap.2021.04.021
• 发表时间: 2021-08
• 期刊: Academic pediatrics
• 影响因子: 3.1
• 作者: Ross MK;Romero T;Szilagyi PG
• 通讯作者: Szilagyi PG

Barriers and facilitators of electronic patient portal uptake for asthma management.

哮喘管理电子患者门户的障碍和促进因素。

• DOI: 10.1080/02770903.2022.2087190
• 发表时间: 2023
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Radparvar,Ilana;Ross,MindyK
• 通讯作者: Ross,MindyK

User Experience Design for Adoption of Asthma Clinical Decision Support Tools.

• DOI: 10.1055/s-0042-1757292
• 发表时间: 2022-08
• 期刊: APPLIED CLINICAL INFORMATICS
• 影响因子: 2.9
• 作者: Gao, Emily;Radparvar, Ilana;Dieu, Holly;Ross, Mindy K.
• 通讯作者: Ross, Mindy K.

Electronic patient portal activation and outcomes among pediatric patients with asthma.

• DOI: 10.1016/j.jaip.2023.03.019
• 发表时间: 2023-06
• 期刊: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
• 影响因子: 9.4
• 作者: Kafashzadeh, Dariush;Hall, Kaitlin;Pirani, Cenan;Szilagyi, Peter G.;Chen, Lucia;Ross, Mindy K.
• 通讯作者: Ross, Mindy K.