MATCHES: Making Telehealth Delivery of Cancer Care at Home Effective and Safe

匹配：使远程医疗在家中提供有效且安全的癌症护理

• 批准号: 10454670
• 负责人: MICHAEL J MORRIS
• 金额: $ 123.9万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10454670
• 关键词: Address; Adoption; Ambulatory Care Facilities; Biological Models; COVID-19 pandemic; Cancer Patient; Caring; Chronic; Clinic; Clinical Medicine; Communication; Computerized Medical Record; Custom; Data; Data Analytics; Data Science; Devices; Diagnosis; Dimensions; Discipline; Diverse Workforce; Dose; Ecosystem; Effectiveness; Electronic Health Record; Ensure; Feedback; Future; Goals; Growth; Health Services; Heart failure; Home; Individual; Informatics; Institute of Medicine (U.S.); Intervention; Intramuscular; Knowledge; Laboratories; Link; Machine Learning; Malignant Neoplasms; Medicine; Metadata; Methods; Modeling; Monitor; New Jersey; New York; Oncology; Oral; Outcome; Outcome Measure; Outpatients; Palliative Care; Patients; Pattern; Persons; Physicians; Prostate Cancer therapy; Quality of Care; Randomized; Research; Research Design; Research Methodology; Research Personnel; Resources; Risk; Rural; Safety; Science; Site; System; Techniques; Testing; Time; Training; Visit; Woman; Work; analytical method; asynchronous communication; base; behavioral health; cancer care; cancer therapy; care delivery; clinical practice; complex data; data streams; design; digital; evidence base; experience; health care quality; health communication; health equity; implementation science; individual patient; innovation; insight; investigator training; mHealth; machine learning method; malignant breast neoplasm; men; multidisciplinary; novel; pandemic disease; patient portal; personalized care; pilot trial; pragmatic trial; precision oncology; prospective; rational design; skills; subcutaneous; survivorship; telehealth; tool; trial comparing; trial design; virtual visit

Project Summary/Abstract The MATCHES (Making Telehealth Delivery of Cancer Care at Home Effective and Safe) Telehealth Research Center aims to build the evidence base necessary to establish best practices for telehealth-enabled cancer care. The overarching goal of the Center is to create a research hub that generates evidence, trains investigators, and develops the research methods required to ignite the field of precision cancer care delivery. Prior work demonstrates that oncology-focused telehealth can achieve favorable outcomes, but large-scale trials have been limited to specific contexts like palliative care or survivorship. Adoption has been constrained by restricted reimbursement. The MATCHES Center will help remediate this evidence gap by executing prospective trials, conducting observational analyses, and training transdisciplinary researchers. Our research theme focuses on the integration of multi-layered data from telehealth platforms, patient portals, mobile tracking devices, and the electronic medical record to develop analytic methods that support personalized care. We aim to develop a new paradigm in oncology—precision delivery—with the ultimate goal of matching individual patients with the most beneficial combination of clinic-based or telehealth-supported home-setting care at the appropriate time—all based on the totality of dynamically available data. We will accomplish this goal by applying data science methods—including nimble trial designs and machine learning—that have had limited application to telehealth to date. By establishing a research hub that nurtures investigators across disciplines and provides training, tools, data, analytic methods, and venues for sharing knowledge and building partnerships, we expect to accelerate progress in the science of care delivery. Our specific aims are 1) to conduct impactful pragmatic trials of telehealth in oncology, 2) to analyze a large existing cache of multidimensional observational data characterizing telehealth utilization and outcomes, 3) to train investigators and equip them with the skills necessary to innovate within an evidence-based framework, and 4) to integrate telehealth with other data streams and create and apply analytic methods to transform the field of precision care delivery. An Administrative Core will coordinate activities and engage feedback from internal and external stakeholders—including patients and the oncology workforce. Our Clinical Practice Network serves as an innovation laboratory and comprises 7 outpatient clinics in NY and NJ with a shared informatics ecosystem including telehealth capacity, digital monitoring, and a highly trafficked patient portal. This will enable us to launch and execute a large pragmatic trial comparing in-person care to telehealth, with resources designed to support home-based care using a cluster-randomized design. The Research & Methods Core will support the Center by applying data science methods to extract and synthesize insights from telehealth and other data streams to develop methods relevant to advancing precision cancer care delivery and the goals of equity, efficacy, and efficiency to create an optimal experience for people being treated for cancer.

项目摘要/摘要 Matches(使远程医疗在家中提供有效和安全的癌症护理)远程医疗研究 该中心的目标是建立必要的证据基础，以建立远程医疗癌症的最佳实践 关心。该中心的首要目标是创建一个研究中心，以产生证据、培训 研究人员，并开发所需的研究方法，以点燃精确的癌症护理提供领域。 先前的工作表明，专注于肿瘤学的远程医疗可以取得良好的结果，但大规模 试验一直局限于特定的情况，如姑息治疗或生存。收养一直受到限制 通过限制报销。匹配中心将通过执行以下操作来帮助弥补这一证据差距 前瞻性试验，进行观察分析，并培训跨学科研究人员。我们的研究 主题侧重于从远程医疗平台、患者门户、移动设备 跟踪设备和电子病历，以开发支持个性化的分析方法 关心。我们的目标是开发一种新的肿瘤学范式-精确交付-最终目标是匹配 以诊所为基础的或远程医疗支持的家庭环境最有益的组合的个体患者 在适当的时间进行护理--所有这些都基于动态可用的全部数据。我们会做到这一点的 目标是应用数据科学方法-包括灵活的试验设计和机器学习-这些方法已经 到目前为止，远程医疗的应用有限。通过建立一个研究中心，培养各地的调查人员 学科，并提供培训、工具、数据、分析方法以及共享知识和构建 在伙伴关系方面，我们希望加快护理提供科学方面的进展。我们的具体目标是1) 在肿瘤学中进行远程医疗的有效实用试验，2)分析现有的大量 表征远程医疗利用和结果的多维观察数据，3)培训调查人员 并让他们掌握在循证框架内创新所需的技能，以及4)整合 与其他数据流进行远程保健，并创建和应用分析方法来转变精度领域 护理服务。行政核心将协调活动，并听取内部和外部的反馈 利益相关者-包括患者和肿瘤学工作人员。我们的临床实践网络作为 创新实验室，由纽约和新泽西州的7家门诊诊所组成，共享信息生态系统 包括远程医疗功能、数字监控和高流量的患者门户。这将使我们能够 启动并执行一项大型务实试验，将面对面护理与远程保健进行比较，其资源旨在 使用群集式随机设计支持基于家庭的护理。研究与方法核心将支持 通过应用数据科学方法从远程医疗和其他数据中提取和综合见解 开发与推进精确癌症护理提供和公平目标相关的方法， 功效和效率，为正在接受癌症治疗的人创造最佳体验。