PRIS-M: Precision Monitoring to Transform Care

PRIS-M：精准监测以改变护理方式

• 批准号: 10021441
• 负责人: Dawn Marie Bravata
• 金额: --
• 依托单位: RLR VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-10-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10021441
• 关键词: Accident and Emergency department; Address; Area; Automobile Driving; Behavior; Caring; Clinical; Clinical Pathways; Clinical Research; Collaborations; Custom; Data; Data Analyses; Data Collection; Data Sources; Decision Making; Development; Diagnostic tests; Disease; Documentation; Electronic Health Record; Engineering; Evaluation; Evidence based intervention; Genetic; Goals; Health Promotion; Healthcare; Healthcare Systems; Individual; Information Systems; Information Technology; Inpatients; Intensive Care Units; Knowledge; Lead; Leadership; Link; Measures; Medical Care Team; Medicine; Methods; Modeling; Monitor; Outcome; Outpatients; Patient-Focused Outcomes; Patients; Persons; Prevention strategy; Provider; Quality of Care; Recording of previous events; Reporting; Research; Right to Treatments; Risk; Service delivery model; Sleep Apnea Syndromes; Source; Standardization; Structure; System; Testing; Time; Transient Ischemic Attack; Ultrasonography; Veterans; Work; acute stroke; adverse outcome; base; behavior change; behavior influence; cancer diagnosis; care outcomes; clinical care; contextual factors; data infrastructure; data warehouse; disorder prevention; electronic data; experience; genetic information; health administration; health care delivery; health care settings; health data; implementation strategy; improved; improved outcome; individual patient; individual variation; innovation; medical specialties; point of care; population health; precision medicine; programs; satisfaction; structured data; support tools; telehealth; tool; treatment strategy; unstructured data; usability

 DESCRIPTION (provided by applicant): Background and Specific Aims The VHA is unquestionably a leader in use of electronic health record (EHR) data to inform clinical, operational, and administrative decisions. Despite the growing granularity and accessibility of these data, however, data are currently most commonly used to retrospectively evaluate quality of care rather than to provide the right data at the right time to the right person in a way that increases patient and staff satisfaction and improves healthcare outcomes. The Precision Monitoring (PRIS-M) to Transform Care program meets this critical need as it aims to: 1) Implement and evaluate electronic clinical quality measures (eCQMs) and decision support tools at the point of care; 2) Conduct scalable clinical quality improvement projects that link electronic data to provider actions and reporting; 3) Investigate the effects of providing actionable EHR-based data on care team and Veteran behaviors and satisfaction; and 4) Identify the implementation strategies and contextual factors that activate VHA providers, leaders, and Veterans to use data to transform care. Methods With the ongoing input of our core partners, these aims will be accomplished via core research and quality improvement projects that cover multiple conditions and care settings. Our projects focus on: 1) national implementation of inpatient eCQMs, 2) testing telehealth modules and eCQMs for improving rapid transient ischemic attack (TIA) care, 3) decision support to deimplement inappropriate carotid ultrasound image ordering, and 4) a local quality improvement project to implement and evaluate a remote sleep apnea monitoring program. In addition, the PRIS-M program includes two additional projects: one to implement and evaluate the first Emergency Department Clinical Pathway decision support tool (acute stroke care) being rolled out to facilities in January 2016, and one to implement a local program of electronic documentation and display of patient behavior change goals to improve coordination and satisfaction with care. These projects are supported by an Implementation and Data Core that works across all projects to facilitate efficient use of data; usability testing of new tools; and standardized use f implementation measures, methods, and analytic approaches. Our overarching implementation strategy focuses on activating individuals and groups to use data to transform care, and we use the CFIR framework to plan data collection and analyses across projects to identify core implementation strategies and contextual factors that impact how people use data to transform care. Key partners include OIA/OABI, the Office of Specialty Care, the National Center for Health Promotion and Disease Prevention, the Office of Telehealth, the Roudebush VAMC, and the VA Center for Applied Systems Engineering. Anticipated impacts The PRIS-M Program directly addresses the Blueprint for Excellence Strategy Three: Leverage information technologies, analytics, and models of healthcare delivery to optimize individual and population health outcomes. Our projects lead directly to the implementation and evaluation of tools that will be useful across all VHA facilities and multiple clinical conditions and settings. We also wil address the important implementation questions about how best to use data to activate providers, healthcare teams, and Veterans to improve healthcare delivery and outcomes. In total, this program will provide multiple new proven tools and strategies for VHA to use as it leads the nation in leveraging its data systems to transform care.

 描述（由申请人提供）： 背景和具体目的旨在VHA Undreesabby Anu电子健康记录（EHR）数据，以告知临床，尽管这些数据的粒度越来越大，但是我的护理质量却不得评估，而不是在右边提供正确的数据 是时候以增加患者和员工的方式来改善医疗保健结果。护理点；核心合作伙伴，这些目标将通过核心核心核心核心核心核心核心和质量改进项目涵盖多个护理设置。攻击（TIA）护理，3）决定符合镜像图像的决定支持，订购和4）当地质量能够实施和评估远程远程无线监控计划。途径支持工具将于2016年1月推出，以改善这些项目的协调。使用数据转换ORK来计划数据收集和分析，以识别核心实施者，而上下文因素thact wowpeople usata transform Care包括OIA/OABI，包括特殊护理办公室，国家远程医疗中心。 Roudebush VAMC和VA应用系统工程中心。设施和多个Condit离子和设置。利用它的国家来利用其数据系统来改变护理。