Leveraging Data to Action: Accelerating Emergency Department OUD Care by Improving Data Access and Infrastructure

利用数据采取行动：通过改善数据访问和基础设施加速急诊科 OUD 护理

• 批准号: 10745526
• 负责人: Kathryn Hawk
• 金额: $ 48.96万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10745526
• 关键词: Acceleration; Accident and Emergency department; Acute myocardial infarction; Address; Algorithms; American; Automation; Benchmarking; Buprenorphine; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Clinical; Clinical Trials; Clinical Trials Network; Collaborations; Data; Data Collection; Data Element; Data Set; Development; Dimensions; Drug usage; Ecosystem; Education; Electronic Health Record; Emergency Care; Emergency Department Physician; Emergency Department patient; Epidemic; Evaluation; FAIR principles; Future; General Population; Healthcare Systems; High Prevalence; Individual; Information Systems; Infrastructure; Intervention; Maps; Measures; Medical; Methadone; Naloxone; National Institute of Drug Abuse; Observational Study; Online Systems; Outcome; Overdose; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Phase; Population Surveillance; Prevention; Prevention education; Process; Public Health; Quality of life; Readiness; Registries; Research; Safety; Sepsis; Site; Standardization; Stroke; Substance Use Disorder; Surgeon; System; Time; Translating; Translational Research; United States; Vertebral column; Work; acute care; clinical care; college; cost effectiveness; dashboard; data access; data infrastructure; data modeling; data registry; design; digital; implementation research; improved; improved outcome; mortality; opioid mortality; opioid overdose; opioid use disorder; overdose death; overdose prevention; prototype; response; therapy development

Abstract Data-driven evaluation and interventions have improved emergency care across an array of acute care conditions including acute myocardial infarction, stroke and sepsis -- yet, similar systems to support and advance emergency care for OUD are lacking amidst worsening patient outcomes. Our team completed foundational data infrastructure work revealing gaps in ED data systems as well as identifying opportunities to utilize the American College of Emergency Physician's Clinical Emergency Department Registry (CEDR) as a national data backbone of over 1000 Emergency Departments (EDs) for OUD care. We propose to create new data processes that will generate a collection of data products embedded within the CEDR ecosystem to improve the timeliness, quality, accessibility, and usefulness of CEDR data to address the overdose epidemic. To address these critical needs, we propose an acceleration project that will leverage our prior work developing and refining electronic health record OUD data elements both within and outside of the CEDR registry. This proposal will: 1) automate OUD-related data extraction from participating sites, 2) map ED data to a standardized, scalable Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) 3) Translate relational data within the CDM into research ready datasets with algorithmic extension of important OUD concepts, and 4) create site and public facing ED OUD overdose prevention dashboards for care improvement and surveillance. We hypothesize that the automation and integration of electronic health record and administrative substance use disorder data into CEDR will improve the ability to identify opportunities for improvement in ED OUD care and advance future research initiatives. During this study we plan to assess digital readiness within CEDR and design an enhanced ED OUD data infrastructure suitable for large scale observational research, support of future real-world clinical trials and benchmarking dashboards (R61 phase) and develop and deploy an ED OUD digital infrastructure across clinical, research and surveillance dimensions (R33 phase). Upon study completion, we anticipate an improved national ED data registry using a standardized common data model, automated site level ED OUD dashboards to guide near-real time local quality improvement initiatives, the existence of an independent ED OUD Registry Research dataset, and a public facing, web based near-real time ED OUD care dashboard.

抽象的 数据驱动的评估和干预措施改善了一系列急症护理的紧急护理 包括急性心肌梗死、中风和败血症在内的疾病——然而，类似的系统可以支持和治疗 在患者预后恶化的情况下，OUD 缺乏预先紧急护理。我们的团队完成了 基础数据基础设施工作揭示了 ED 数据系统的差距并确定了机会 利用美国急诊医师学院的临床急诊科登记处 (CEDR) 作为 超过 1000 个急诊科 (ED) 的 OUD 护理国家数据骨干。我们建议创建新的 数据处理将生成嵌入 CEDR 生态系统中的数据产品集合 提高 CEDR 数据的及时性、质量、可访问性和有用性，以解决药物过量流行问题。 为了满足这些关键需求，我们提出了一个加速项目，该项目将利用我们之前的工作 在 CEDR 内部和外部开发和完善电子健康记录 OUD 数据元素 注册表。该提案将：1）自动从参与站点提取 OUD 相关数据，2）将 ED 数据映射到 标准化、可扩展的观察性医疗结果合作伙伴关系 (OMOP) 通用数据模型 (CDM) 3) 将 CDM 中的关系数据转换为可用于研究的数据集，并具有算法扩展 重要的 OUD 概念，以及 4) 创建站点和面向公众的 ED OUD 过量预防仪表板 护理改善和监测。我们假设电子医疗的自动化和集成 将药物使用障碍数据记录和管理到 CEDR 将提高识别能力 改善 ED OUD 护理和推进未来研究计划的机会。在这项研究期间我们 计划评估 CEDR 内的数字化准备情况并设计增强的 ED OUD 数据基础设施 适用于大规模观察研究，支持未来的真实临床试验和基准测试 仪表板（R61 阶段）并开发和部署跨临床的 ED OUD 数字基础设施， 研究和监测维度（R33 阶段）。研究完成后，我们预计会有改进 使用标准化通用数据模型、自动化站点级 ED OUD 仪表板的国家 ED 数据注册中心 为了指导近乎实时的本地质量改进计划，存在独立的 ED OUD 注册中心 研究数据集以及面向公众、基于网络的近实时 ED OUD 护理仪表板。