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

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 第一阶段项目使用混合方法正式评估策略来开发、测试和评估 Breezmed 的 alpha 原型，这是一个基于网络的即时电子事先授权平台。授权给当前的医疗系统带来了负担，阻碍了提供者有效开药的能力药物治疗和及时治疗通常会导致患者不依从治疗。对于精神疾病来说尤其困难，通常需要通过处方药物快速稳定病情。还有证据表明，如果药物昂贵或难以获得，治疗依从性就会很高。此外，大量的经验证据强化了由于单调乏味而导致的高水平的提供者倦怠需要获得保险公司的事先授权提供商以电子方式传输之间的时间间隔。药房的处方以及实际配药的时间也会给患者带来负担，他们通常会发现仅当他们最近前往药房获取药物后，他们的药物才受到承保。 AMA 和其他医疗保健倡导组织对提供者进行的调查显示，损失相当大原本可以谨慎用于提供治疗的工作时间，但却被分配给同行咨询或填写保险审批所需的表格这些手动流程消耗了宝贵的资源。 Breezmed 提供了软件即解决方案。基于网络的平台，可与现有电子健康记录系统无缝、安全地集成。提供商在护理点启动 Breezmed，获取诊断信息、患者治疗史、该平台提供有效订购药物的保险授权要求和处方规则。具有可观的经济和社会效益，并且可以以最少的工作流程安全地搭载现有的 EHR 拟议的研究涉及三个综合部门，包括消费者偏好调查。由全国招募的医生、执业护士、医生助理组成的小组管理从这个小组样本中，我们进一步招募焦点小组来进行更详细的探索。我们还利用关键知情人访谈来消除事先授权的障碍并探索计算机介导的解决方案。与医院管理人员、医疗信息学领域的医疗技术专家和保险公司合作，并使用此构建 Breezmed 线框架构的详细信息我们还使用一个进行实时可用性测试。模拟 EHR 并测试与 EPIC 医疗记录系统的应用程序接口，以确保我们与 Omaha-H4 技术合作。总部位于网络应用程序开发公司，以及内布拉斯加大学方法论和评估研究核心负责实施咨询委员会的形成性评估项目。拥有医疗保健和信息技术方面的专业知识，以及 UNMC 经验丰富的教师团队，牧人及时执行补助。