Breast Cancer Screening and Follow-up in a PBRN: The Ma*

PBRN 中的乳腺癌筛查和随访：Ma*

• 批准号: 7229808
• 负责人: MICHAEL J BARRY
• 金额: $ 16.53万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7229808
• 关键词: Arizona; Breast Cancer Detection; Caring; Characteristics; Clinic Visits; Clinical; Failure; Health; Health system; Heart; Informatics; Information Technology; Intervention; Link; Mammography; Medical; Patients; Physicians; Play; Population; Practice based research; Primary Health Care; Process; Provider; Public Health Informatics; Randomized Controlled Clinical Trials; Rate; Research; Resources; Role; Screening for cancer; Screening procedure; System; Universities; base; care delivery; follow-up; health care service organization; improved; intervention program; novel; programs; provider intervention; success; tool

DESCRIPTION (PROVIDED BY APPLICANT): University of Arizona, Sarver Heart Center Health care organizations play a central role in improving the process of breast cancer screening and follow-up. For patients receiving regular care within a medical system, sub-optimal mammography screening rates represent a significant system-level failure in care delivery. Research efforts to overcome barriers to screening success and effective follow-up must therefore move from an exclusively patient or physician focus to include the process of care delivery within health systems. Because primary care providers (PCPs) are the key decision makers in a practice network, we hypothesize that correctly classifying patients based on linkage to a specific PCP will create a mechanism to efficiently allocate resources and interventions to change care. For patients with a close PCP linkage, interventions to improve mammography screening rates can be focused through the physician, whereas for patients who receive care (often episodic) from within the system but without close linkage to a PCP, interventions can be directed through a practice manager. We propose to closely couple identifying the right provider for a patient to the use of clinical health informatics systems that link information to action and that can be easily used independent of clinic visits to enhance primary care cancer screening. We will implement an informatics-based population management tool for use by PCPs or practice managers in a controlled trial within our Practice-Based Research Network (PBRN). Specific Aim 1: To classify all patients within the MGPC-PBRN according to patient-PCP linkage status and to describe the characteristics of patients with close linkage to a PCP ("PCP loyal") or not ("Practice loyal"). Specific Aim 2: To develop and implement a novel breast cancer screening intervention program called Mammography FastTrack to facilitate ordering and tracking of mammograms that can be used by either PCPs (for PCP-loyal patients) or by practice managers (for practice-loyal patients). Specific Aim 3: To perform a group randomized trial of the Mammography FastTrack program within the MGPC-PBRN to increase mammography screening rates in both PCP-loyal and Practice-loyal eligible patients overdue for breast cancer screening. This research is relevant to nationwide efforts to modernize and improve health information technology capabilities. We will create a process to track all patients within our PBRN and to reduce current barriers to ordering and following up of abnormal mammogram results.

描述（由申请人提供）：亚利桑那大学萨弗心脏中心医疗保健组织在改善乳腺癌筛查和随访过程中发挥着核心作用。 对于在医疗系统内接受定期护理的患者来说，次优的乳房 X 光检查筛查率代表着护理服务中系统级的重大失败。因此，克服筛查成功和有效随访障碍的研究工作必须从仅仅关注患者或医生转向包括卫生系统内的护理提供过程。由于初级保健提供者 (PCP) 是实践网络中的关键决策者，我们假设根据与特定 PCP 的联系对患者进行正确分类将创建一种有效分配资源和干预措施以改变护理的机制。对于与 PCP 有密切联系的患者，可以通过医生集中采取干预措施来提高乳房 X 光检查筛查率，而对于从系统内部接受护理（通常是间歇性）但与 PCP 没有密切联系的患者，可以通过实践来指导干预措施经理。我们建议将为患者确定合适的提供者与临床健康信息系统的使用紧密结合起来，该系统将信息与行动联系起来，并且可以独立于诊所就诊而轻松使用，以加强初级保健癌症筛查。我们将实施基于信息学的人口管理工具，供 PCP 或实践管理者在我们基于实践的研究网络 (PBRN) 内的对照试验中使用。具体目标 1：根据患者与 PCP 联系状态对 MGPC-PBRN 内的所有患者进行分类，并描述与 PCP 密切联系（“PCP 忠诚”）或不密切联系（“实践忠诚”）的患者的特征。具体目标 2：开发和实施一种名为乳房 X 光检查 FastTrack 的新型乳腺癌筛查干预计划，以促进乳房 X 光检查的订购和跟踪，可供 PCP（对于 PCP 忠诚的患者）或实践管理者（对于实践忠诚的患者）使用。具体目标 3：在 MGPC-PBRN 内进行乳房 X 光检查 FastTrack 计划的分组随机试验，以提高逾期未进行乳腺癌筛查的 PCP 忠诚和实践忠诚合格患者的乳房 X 光检查筛查率。这项研究与全国范围内的卫生信息技术现代化和提高能力的努力相关。我们将创建一个流程来跟踪 PBRN 内的所有患者，并减少当前订购和跟踪异常乳房 X 光检查结果的障碍。

项目成果

A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial.

社区卫生中心针对结直肠癌筛查的文化定制导航计划：一项随机对照试验。

• 发表时间: 2009-02
• 影响因子: 5.7
• 作者: Percac;Grant, Richard W;Green, Alexander R;Ashburner, Jeffrey M;Gamba, Gloria;Oo, Sarah;Richter, James M;Atlas, Steven J
• 通讯作者: Atlas, Steven J

Population-based breast cancer screening in a primary care network.

初级保健网络中基于人群的乳腺癌筛查。

• 发表时间: 2012
• 作者: Atlas, Steven J;Ashburner, Jeffrey M;Chang, Yuchiao;Lester, William T;Barry, Michael J;Grant, Richard W
• 通讯作者: Grant, Richard W