A novel platform to facilitate provider adoption of cognitive care planning

一个促进提供者采用认知护理计划的新颖平台

基本信息

批准号：
10707975
负责人：
Bin Huang
金额：
$ 72.78万
依托单位：
BRAINCHECK, INC.
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-30 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10707975
关键词：
Address Adopted Adoption Advance Care Planning Agitation Alzheimer&apos s Disease Alzheimer&apos s disease care Alzheimer&apos s disease patient Alzheimer&apos s disease related dementia Assisted Living Facilities Behavioral Caregivers Caring Clinic Visits Code Cognitive Communication Consumption Data Data Reporting Dementia Disease Progression Elderly Emotional Fall prevention Feedback Frequencies Goals Health Health Benefit Health Status Impaired cognition Incentives Individual Intervention Investments Knowledge Life Style Managed Care Measures Medical Medicare claim Meta-Analysis Motion Names Participant Patient-Centered Care Patients Personal Satisfaction Pharmacologic Substance Phase Physicians Prevention strategy Primary Care Physician Progressive Disease Provider Psyche structure Qualifying Quality of life Recommendation Reporting Safety Management Services Specialist Speed Standardization Technology Testing Time Training Translating United States Centers for Medicare and Medicaid Services Work burden of illness care burden care providers clinical practice cognitive ability cognitive benefits cognitive function cognitive testing design end of life experience falls follow-up improved indexing mobile computing neuropsychiatric symptom novel patient oriented patient population phase 2 study prevent primary care provider prototype provider adoption routine care success tool treatment as usual validation studies

项目摘要

SUMMARY Alzheimer's Disease and Alzheimer's Disease and Related Dementias (AD/ADRD) are progressive diseases in which patients’ physical and cognitive abilities decline precipitously over time. Although there is currently no cure and very few pharmaceutical-based treatment options, some interventions can help improve patient health and quality of life. Cognitive care planning (CCP) refers to the practice of systematically compiling and communicating personalized recommendations and directions for follow-up care to AD/ADRD patients. This activity can lead to better care management, thus benefiting the health and well-being of both patients and their caregivers. Despite this, CCP is scarcely seen in routine care and several barriers attribute to the slow adoption rate. First, CCP is time consuming due to the sizable amount of content to assemble; cognitive assessment data, emotional health status, and caregiver knowledge, to name a few. Second, the expertise required to interpret patient information and generate individualized recommendations for care can be daunting to non-specialists; whereas due to a shortage of dementia specialists, the burden of care for this patient population most often falls to non-specialist primary care physicians (PCPs). The considerable time invested into developing a care plan results in a financial barrier as well. In 2018 a new billing code was established to address this but reimbursements rates remain low. BrainCheck has an overarching goal to enhance the adoption of formal CCP as part of routine care for AD/ADRD patients. We have developed an app-based tool that integrates assessment scores, provider input, and patient/caregiver reported data to generate an individualized, easy-to-read document to be delivered during a clinic visit. A prototype of this tool, BC-Care™, was positively received by an initial group of specialist and non-specialist users and their feedback was used to iterate on key features and user interface design. Moreover, clinical practices reported greater success in claiming Medicare reimbursement after using BC-Care. Based on this preliminary work, we believe BC-Care makes care planning faster, more accessible, and more likely to be reimbursed. Here, we propose Phase II studies to systematically validate the impact of BC-Care on the adoption of CCP. Specifically, we will: measure the time spent on care planning, care plan completion rate, and reimbursement success rate for providers using BC-Care (Aim 1); compare the extent to which providers adopt care planning before and after gaining access to the BC-Care tool (Aim 2); and track specific impacts on health and well-being among patients and caregivers who received a care plan via BC-Care compared to those receiving care-as-usual (Aim 3). By addressing three of the major barriers preventing providers from offering care planning services to their patients with AD/ADRD, we predict our technological solution will substantially enhance adoption, thus offering a realistic path toward improving health and well-being by improving the approach to routine cognitive care.

概括阿尔茨海默病和阿尔茨海默病及相关痴呆 (AD/ADRD) 是进行性疾病随着时间的推移，患者的身体和认知能力急剧下降，尽管目前还没有这种情况。治愈和基于药物的治疗选择很少，一些干预措施可以帮助改善患者健康和生活质量认知护理规划（CCP）是指系统地编制和制定的实践。向 AD/ADRD 患者传达个性化建议和后续护理指导。活动可以带来更好的护理管理，从而有利于患者和患者的健康和福祉尽管如此，CCP 却很少出现在日常护理中，而且缓慢造成了一些障碍。首先，由于需要收集大量内容，CCP 非常耗时；评估数据、情绪健康状况和护理人员知识等等。其次，专业知识。解释患者信息并生成个性化护理建议可能令人望而生畏对于非专家来说；而由于缺乏痴呆症专家，该患者的护理负担最常由非专科初级保健医生 (PCP) 投入。制定护理计划也导致了财务障碍，2018 年制定了新的计费代码。解决这个问题，但报销率仍然很低。 BrainCheck 的总体目标是加强正式 CCP 的采用，将其作为常规护理的一部分我们开发了一种基于应用程序的工具，集成了评估分数、提供者输入、以及患者/护理人员报告的数据，以生成要交付的个性化、易于阅读的文档在一次临床访问期间，该工具的原型 BC-Care™ 受到了最初一组专家的积极评价。和非专业用户，他们的反馈被用来迭代关键功能和用户界面设计。此外，临床实践报告称，使用 BC-Care 后在申请医疗保险报销方面取得了更大的成功。基于这项初步工作，我们相信 BC-Care 可以使护理计划更快、更容易获得，并且更多在这里，我们建议进行第二阶段研究来系统地验证 BC-Care 对患者的影响。具体来说，我们将：衡量护理计划花费的时间、护理计划完成率、以及使用 BC-Care 的提供商的报销成功率（目标 1）；比较提供商的程度；在使用 BC-Care 工具之前和之后采用护理计划（目标 2）并跟踪对以下方面的具体影响；与通过 BC-Care 接受护理计划的患者和护理人员相比，他们的健康和福祉照常接受护理（目标 3）。通过解决阻碍提供者向其提供护理计划服务的三个主要障碍 AD/ADRD 患者，我们预测我们的技术解决方案将大大提高采用率，从而提供通过改进常规认知护理方法来改善健康和福祉的现实途径。