An Economical Point-of-Care Software Solution Prototype for Medication Prior Authorization

用于药物事先授权的经济型护理点软件解决方案原型

基本信息

批准号：
10079987
负责人：
Stephen Salzbrenner
金额：
$ 30.14万
依托单位：
BREEZMED, LLC
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10079987
关键词：
Address Algorithms Architecture Authorization documentation Automation Beds Caring Clinic Clinical Collaborations Computer software Computerized Medical Record Computers Consultations Consumer Preferences Consumption Data Development Diagnosis Diagnostic Economics Electronic Health Record Emergency department visit Ensure Environment Evaluation Research Expenditure Faculty Feedback Focus Groups Formularies Grant Health Health Insurance Portability and Accountability Act Health Technology Healthcare Healthcare Systems Hospital Administrators Hospitalization Hour Information Technology Insurance Insurance Carriers Insurance Coverage Interview Knowledge Lead Link Manuals Martes zibellina Mediating Medical Medical History Medical Informatics Medical Records Medical Staff Mental Health Mental disorders Methodology Methods Nebraska Nurse Practitioners Online Systems Participant Patient Care Patients Pharmaceutical Preparations Pharmacists Pharmacy facility Phase Phase II Clinical Trials Physician Assistants Physicians Process Provider Recording of previous events Recurrence Relapse Reporting Resources Sampling Secure Small Business Technology Transfer Research Source Surveys System Technology Testing Time Travel Universities advocacy organizations application programming interface arm behavioral economics burnout clinical practice community based participatory research compliance behavior cost efficient experience formative assessment health care availability health care delivery hospitalization rates improved informant innovation non-compliance peer point of care prior authorization prototype recruit satisfaction societal costs software as a service stem usability web app web platform

Address Algorithms Architecture Authorization documentation Automation Beds Caring Clinic Clinical Collaborations Computer software Computerized Medical Record Computers Consultations Consumer Preferences Consumption Data Development Diagnosis Diagnostic Economics Electronic Health Record Emergency department visit Ensure Environment Evaluation Research Expenditure Faculty Feedback Focus Groups Formularies Grant Health Health Insurance Portability and Accountability Act Health Technology Healthcare Healthcare Systems Hospital Administrators Hospitalization Hour Information Technology Insurance Insurance Carriers Insurance Coverage Interview Knowledge Lead Link Manuals Martes zibellina Mediating Medical Medical History Medical Informatics Medical Records Medical Staff Mental Health Mental disorders Methodology Methods Nebraska Nurse Practitioners Online Systems Participant Patient Care Patients Pharmaceutical Preparations Pharmacists Pharmacy facility Phase Phase II Clinical Trials Physician Assistants Physicians Process Provider Recording of previous events Recurrence Relapse Reporting Resources Sampling Secure Small Business Technology Transfer Research Source Surveys System Technology Testing Time Travel Universities advocacy organizations application programming interface arm behavioral economics burnout clinical practice community based participatory research compliance behavior cost efficient experience formative assessment health care availability health care delivery hospitalization rates improved informant innovation non-compliance peer point of care prior authorization prototype recruit satisfaction societal costs software as a service stem usability web app web platform

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项目摘要

ABSTRACT This STTR Phase I project uses mixed-method formative evaluation strategies to develop, test, and evaluate an alpha prototype of Breezmed, a point-of-care electronic prior authorization web-based platform. Prior authorization burdens the current medical system, hampering a provider’s ability to efficiently prescribe medication and in a timely fashion. This often leads to treatment non-compliance among patients and is particularly onerous for mental illnesses, which often require rapid stabilization with prescription medication. There is also evidence of high treatment non-compliance if medications are expensive or difficult to obtain. Moreover, substantial empirical evidence reinforces high levels of provider burnout stemming from the tedium required to obtain prior authorization from insurers. The lag between when the provider electronically transmits the prescription to the pharmacy and when actual dispensing occurs burdens patients too, who routinely find out their medication is not covered only after they have traveled to the pharmacy to obtain the medication. Recent surveys of providers conducted by AMA and other healthcare advocacy organizations show a considerable loss of workforce hours that could be prudently spent providing treatment, but is instead allocated to peer-to-peer consultations or completing forms required for insurance approval. These manual processes consume precious time and resources and detract from needed clinical practice time. Breezmed offers a software-as-a-solution web-based platform that seamlessly and securely integrates with existing electronic health record systems. The provider initiates Breezmed at the point-of-care drawing off diagnostic information, patient treatment history, insurance authorization requirements and formulary rules to efficiently order medication. The platform offers considerable economic and societal benefits and can securely piggyback to existing EHRs with minimal workflow disruption. The proposed study involves three integrated arms including a consumer preference survey administered to a nationally recruited panel of physicians, nurse practitioners, physician assistants, and pharmacists. From this panel sample we further recruit focus group participants to explore in greater detail barriers to prior authorization and probe computer-mediated solutions. We also utilize key informant interviews with hospital administrators, healthcare technology experts in medical informatics, and insurers, and use this detailed information to construct Breezmed’s wireframe architecture. We also conduct live usability tests with a simulated EHR and test the Application Program Interface with the EPIC medical records system to ensure smooth linkages in a secure HIPAA compliant environment. We have partnered with H4 technology, an Omaha- based web application development company, and also the University of Nebraska Methodology and Evaluation Research Core to conduct the formative evaluation components. The project benefits from an advisory board with expertise in medical care and information technology, and a team of experienced faculty at UNMC to shepherd timely execution of the grant.

抽象的该STTR I期项目使用混合方法形成性评估策略来开发，测试和评估 BreezMed的Alpha原型，这是一个护理点电子的先验授权基于Web的平台。事先的授权伯恩伦斯当前的医疗系统，阻碍了提供商有效开处方的能力药物和及时的方式。这通常会导致患者之间的治疗不合规，IS 对于精神疾病特别繁重，通常需要使用处方药快速稳定。如果药物昂贵或难以获得，也有证据表明，高度治疗不合规。此外，大量的经验证据加强了由乏味的高水平提供者的倦怠要求从确保获得事先授权。当提供商电子传输之间的滞后药房的处方以及实际分发也发生了伯恩斯患者，他们通常会发现仅在他们去药房获得药物治疗后，他们的药物不涵盖。最近的 AMA和其他医疗保健倡导组织对提供者进行的调查显示了相当大的损失可以谨慎地花费提供治疗的劳动力时间，而是分配给点对点咨询或填写保险批准所需的表格。这些手动过程消耗了珍贵时间和资源，并损害所需的临床实践时间。 Breezmed提供了一个软件基于Web的平台，无缝且与现有的电子健康记录系统无缝并安全地集成。这提供者在护理点上启动诊断信息，患者治疗病史，保险授权要求和公式化规则，以有效订购药物。平台提供巨大的经济和社会福利，可以用最小的工作流程将现有的EHR牢固地背包破坏。拟议的研究涉及三个集成的武器，包括消费者偏好调查管理由全国招募的医师，护士从业人员，医师助理和药剂师。在此面板样本中，我们进一步招募了焦点小组参与者，以更详细地探索事先授权和探测计算机介导的解决方案的障碍。我们还利用关键的线人访谈与医院管理员，医疗保健技术专家有关医疗信息的专家并确保并使用详细信息以构建微风的线框体系结构。我们还通过模拟EHR并与Epic医疗记录系统测试申请程序接口，以确保在安全HIPAA的环境中平稳链接。我们已经与奥马哈的H4 Technology合作基于Web应用程序开发公司以及内布拉斯加州大学的方法论和评估进行形成性评估组件的研究核心。该项目受益于顾问委员会拥有医疗和信息技术方面的专业知识，以及UNMC的一支经验丰富的教师团队牧羊人及时执行赠款。