Use of connected health technology to optimize outcomes for high risk pediatric patients with type 1 diabetes

利用互联健康技术优化 1 型糖尿病高危儿科患者的治疗结果

• 批准号: 10252898
• 负责人: Stephanie Crossen
• 金额: $ 16.25万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-05-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10252898
• 关键词: Adolescent; Behavioral; Blood Vessels; Bluetooth; Caring; Cellular Phone; Child; Childhood; Chronic; Clinic Visits; Clinical; Collaborations; Complications of Diabetes Mellitus; Cost Effectiveness Analysis; Data; Devices; Diabetes Mellitus; Effectiveness; Effectiveness of Interventions; Enrollment; Feedback; Frequencies; Funding; Future; Glycosylated hemoglobin A; Goals; Health; Health Insurance Portability and Accountability Act; Health Services Accessibility; Health Technology; Heterogeneity; Home; Hybrids; Incidence; Insulin; Insulin-Dependent Diabetes Mellitus; Internet; Intervention; Leadership; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Microvascular Dysfunction; Modeling; Monitor; Outcome; Participant; Patient-Centered Care; Patients; Persons; Pilot Projects; Population; Positioning Attribute; Provider; Psychometrics; Public Health Informatics; Research; Research Personnel; Research Proposals; Respondent; Risk; Sampling; Secondary to; Secure; Survey Methodology; Surveys; Technology; Telemedicine; Therapeutic; Time; Training; Videoconferencing; Visit; Youth; automated analysis; base; care delivery; care outcomes; cohort; connected health; cost effectiveness; data sharing; design; diabetes control; diabetes management; experience; follow-up; glucose monitor; glycemic control; health care service utilization; health data; high risk; improved; innovation; interest; macrovascular disease; monitoring device; outreach; participant retention; pediatric health outcomes; pediatric patients; randomized trial; remote monitoring; remote patient monitoring; response; retention rate; secondary outcome; skills; standard of care; telehealth; treatment effect; video visit

PROJECT SUMMARY / ABSTRACT This project investigates the utility and cost-effectiveness of patient-to-provider home-based video encounters, as well as the feasibility of remote monitoring of patient-collected health data for children and adolescents with type 1 diabetes (T1D). Although therapeutic options for T1D have advanced phenomenally in the last decade, measures of glycemic control in youth with T1D have not improved over this time frame. This gap between the potential efficacy of current treatments and their effectiveness in the clinical population illustrates a need for improved delivery of care. The current availability of secure, HIPAA-compliant platforms for video conferencing and remote data-sharing between patients and providers – combined with widespread patient access to “smart devices” with internet, Bluetooth and audio-video capabilities – presents the opportunity to develop innovative new models for delivery of T1D care. This proposal will investigate two such models via the following Specific Aims: AIM 1 – Conduct a randomized trial to evaluate the impact of supplemental home-based video visits on glycemic control, healthcare utilization, and patient experience for pediatric patients with T1D and suboptimal glycemic control. AIM 2 – Model the cost-effectiveness of supplemental home-based video visits for pediatric T1D patients with suboptimal glycemic control. AIM 3 – Evaluate the feasibility of remote monitoring – including automated analysis of patient-generated diabetes data to identify high-risk indicators between in-person visits – for pediatric patients with T1D. The long-term goal of this research is to establish how telehealth technology can best be used to supplement in-person care in ways that improve patient experience, cost-effectiveness, and health outcomes for pediatric patients with T1D. In parallel to completion of these research aims, the candidate will undertake an individualized course of study to attain key skills in the arenas of health informatics, cost-effectiveness analysis, psychometrics and survey methods, patient-centered care delivery, and leadership and mentoring. This training, in combination with an outstanding mentorship team and strong institutional support, will position the candidate ideally to compete subsequently for independent research funding at an R01 level, and to establish herself as a leading researcher in the arena of telehealth technology for pediatric T1D management.

项目摘要 /摘要 该项目调查了基于患者的家庭视频相遇的实用性和成本效益， 以及对儿童和青少年远程监控患者收集的健康数据的可行性 1型糖尿病（T1D）。尽管T1D的治疗选择在过去十年中具有晚期现象 在此时间范围内，T1D青年血糖控制的度量尚未得到改善。这个差距 当前治疗的潜在有效性及其在临床人群中的有效性表明了需要 改善了护理的交付。当前可用于视频会议的安全，符合HIPAA的平台的可用性 以及患者和提供者之间的远程数据共享 - 结合宽度的患者访问“ Smart 设备”具有互联网，蓝牙和音频视频功能 - 提供了开发创新的机会 提供T1D护理的新型号。该提案将通过以下特定的特定模型调查两个这样的模型 目的：目标1 - 进行随机试验，以评估补充家庭视频访问的影响 T1D和次优的儿科患者的血糖控制，医疗保健利用和患者经验 血糖控制。 AIM 2 - 建模儿科补充家庭视频访问的成本效益 T1D患者具有次优血糖对照的患者。 AIM 3 - 评估远程监控的可行性 - 包括 对患者生成的糖尿病数据的自动分析，以识别面对面访问之间的高风险指标 - 针对T1D的小儿患者。这项研究的长期目标是建立远程医疗技术 最好以改善患者经验，成本效益， 小儿T1D患者的健康结果。与这些研究的目的同时， 候选人将进行个性化的学习课程，以在健康领域获得关键技能 信息信息，成本效益分析，精神计算学和调查方法，以患者为中心的护理服务， 以及领导力和心理。这项培训，结合了杰出的精通团队和强大的培训 机构支持，将理想地定位候选人，以便随后竞争独立研究 在R01级别的资金，并在远程医疗技术领域建立自己的领先研究员 用于小儿T1D管理。