Enhancing Electronic Health Systems to Decrease the Burden of Colon Cancer, Lung Cancer, Obesity, Vaccine-Preventable Illness, and Liver Cancer (CLOVER)

加强电子卫生系统以减轻结肠癌、肺癌、肥胖、疫苗可预防疾病和肝癌的负担 (CLOVER)

基本信息

批准号：
10238837
负责人：
Eric W Chak
金额：
$ 29.38万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
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：
2020-08-15 至 2022-07-31
项目状态：
已结题

项目摘要

PROJECT SUMMARY With the goal of improving medical care and reducing health disparities for the aging American population, the University of California, Davis (UCD) and University of California, Irvine (UCI) have collaborated to propose “Enhancing Electronic Health Systems to Decrease the Burden of Colon Cancer, Lung Cancer, Obesity, Vaccine-Preventable Illness, and LivER Cancer” (“CLOVER”). The overall goal of CLOVER is to develop, deliver, and disseminate electronic health systems (EHR)-based interventions that will improve the well-being of older adults through increasing the adherence to selected US Preventive Services Task Force (USPSTF) Grade A and Grade B recommendations and Centers for Disease Control and Prevention (CDC) vaccination recommendations. We will accomplish this goal through pilot (R61) and clinical trial (R33) phases using the following Specific Aims: Aim #1 (R61): Conduct Stage I Behavioral Intervention Development by algorithm development and testing of Epic Healthy Planet (HP) at UCD to identify patients at risk, but never screened for colon cancer or lung cancer. Aim #2 (R61 and R33): Utilizing the enhanced Epic HP, pilot-test evidence-based and customized interventions at both UCD and UCI to increase colon and lung cancer screening rate for at-risk individuals by 10%. Aim #3 (R61 and R33): Determine effectiveness of “bundled ordering” by assessing patients prior to their primary care visit for eligibility for colon and lung cancer screening, tobacco and obesity counseling, age-appropriate vaccination, and hepatitis C screening compared to single procedures in terms of time-saved. Aim #4 (R33): Conduct Stage IV Behavioral Intervention Development by expansion of CLOVER to the UCI federally qualified health center. Aim #5 (R61 and R33): Evaluate the impact of CLOVER on increasing adherence to selected USPSTF recommendations and reducing their disparities by demographic group. CLOVER will cleverly tailor Epic HP to institute 3 key interventions with multi-centered dissemination which will increase the aforementioned screenings, counseling, and vaccinations: 1) Electronic “bulk messaging” through the UCD patient-physician portal using messages that resonate by racial/ethnic groups, 2) “Bundled ordering” will be used by CLOVER staff to fulfill deficiencies in USPSTF and CDC recommendations simultaneously. This will include the use of the emerging technology video visits by which patients will connect to certified tobacco and obesity counselors using their smart phones without the need to travel to an appointment, and 3) “Tailored Health Maintenance” section in the patient's electronic medical chart will alert their PCP of remaining “care gaps” in USPSTF and CDC recommendations and facilitate shared decision making for patients who need additional counseling. If these Aims are achieved, adherence to USPSTF recommendations will be enhanced, and Epic, the EHR company who serves more than 250 million patients will consider incorporating CLOVER into its Foundation System for all organizations to consider adopting our approach.

项目摘要为了改善医疗保健并减少美国老龄化人群的健康差异，加利福尼亚大学戴维斯分校（UCD）和加利福尼亚大学尔湾分校（UCI）已合作提出建议 “增强电子卫生系统以减轻结肠癌，肺癌，肥胖症的负担可预防疫苗的疾病和肝癌”（“三叶草”）。三叶草的总体目标是发展，发展提供并传播基于电子卫生系统（EHR）的干预措施，以改善老年人通过增加对选定的美国预防服务工作队（USPSTF）等级的遵守 A和B级B级建议以及疾病控制与预防中心（CDC）疫苗接种建议。我们将使用试点（R61）和临床试验（R33）阶段实现这一目标以下特定目的：目标＃1（R61）：通过算法进行I阶段行为干预开发在UCD开发和测试EPIC健康星球（HP）以识别有风险的患者，但从未筛选结肠癌或肺癌。 AIM＃2（R61和R33）：利用增强的史诗般的HP，试验基于证据以及UCD和UCI的定制干预措施，以提高处于风险的结肠和肺癌筛查率个人比10％。 AIM＃3（R61和R33）：通过评估患者来确定“捆绑订购”的有效性在获得初级保健访问之前与单个程序相比，适合年龄的疫苗和丙型肝炎筛查。目标＃4（R33）：通过将三叶草扩展到UCI来进行IV阶段的行为干预发展联邦资格卫生中心。目标＃5（R61和R33）：评估三叶草对增加的影响遵守选定的USPSTF建议并通过人口统计组减少其差异。三叶草将巧妙地量身定制史诗般的HP，以进行以多为中心的传播进行3种关键干预措施增加预先提前的筛查，咨询和疫苗接种：1）通过电子“批量消息”通过使用种族/族裔共鸣的消息，UCD患者 - 物理学的门户，2）“捆绑订购” 三叶草员工将简单地使用USPSTF和CDC建议中的缺陷。这将包括使用新兴技术视频访问和肥胖硬币使用智能手机无需前往预约，3）量身定制患者电子医疗图表中的健康维护”部分将提醒其PCP剩余的“护理差距” 在USPSTF和CDC建议中，并为需要额外的患者提供共同的决策咨询。如果实现了这些目标，将加强对USPSTF建议的遵守，并且史诗为超过2.5亿患者服务的EHR公司将考虑将三叶草纳入其所有组织都可以考虑采用我们的方法。