Development of a cloud-based, self-report SUD intake system enabling primary care clinicians to routinely complete, implement, document, and bill for biopsychosocial assessments for the underserved

开发基于云的自我报告 SUD 摄入系统，使初级保健临床医生能够定期为服务不足的人群完成、实施、记录生物心理社会评估并开具账单

• 批准号: 10469898
• 负责人: BENJAMIN B BRODEY
• 金额: $ 25.61万
• 依托单位: TELESAGE, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469898
• 关键词: Address; Affect; Attention; Behavior; Caring; Cellular Phone; Chronic; Client; Clinic; Clinical; Code; Complement; Complex; Computer software; Cost Analysis; Custom; DSM-V; Development; Devices; Diagnosis; Diagnostic; Documentation; Drug usage; Evaluation; Family; Feedback; Goals; Gold; Health Insurance Portability and Accountability Act; Health Personnel; Health Professional; Incentives; Individual; Insurance; Intake; Intuition; Life Style; Link; Medicaid; Medical; Medicare; Mental disorders; Modeling; Nature; Occupational; Patient Self-Report; Patients; Persons; Phase; PhenX Toolkit; Primary Health Care; Privatization; Process; Protocols documentation; Provider; Reading; Recommendation; Recording of previous events; Reporting; Resources; Running; Social support; Software Tools; Speech; Substance Use Disorder; Symptoms; System; Tablets; Testing; Text; Time; Training; Underserved Population; Visual impairment; Vulnerable Populations; Work; Writing; base; behavioral health; biopsychosocial; cloud based; cost; cost effective; design; diagnostic platform; digital; dual diagnosis; fifth grade; flexibility; health care availability; health care delivery; help-seeking behavior; literacy; mHealth; medical specialties; mental state; personalized diagnostics; personalized medicine; prevent; provider behavior; response; screening; self help; social; software development; standard care; support tools; symposium; tool; treatment guidelines; treatment planning; user-friendly; willingness

Project Summary The US healthcare delivery system suffers from intractable problems that increasingly prevent it from identifying and treating people suffering from SUDs. Primary care clinicians, the front line of our health care delivery system, have neither adequate tools nor incentives to evaluate SUDs and co-occurring mental health disorders. The result is chronic under-diagnosis and under-treatment, in addition to the associated adverse personal and societal impacts. These shortcomings disproportionately affect individuals from underserved populations who already have poor access to health care resources. We propose to develop and test a new Primary Care-SUD-Intake System (P-SUD-IS) that is intended to address the problem of under-diagnosis by changing primary care clinician behavior and motivating clients with previously undiagnosed SUDs to seek help. The P-SUD-IS will be a HIPAA-compliant, user-friendly, automated, and cloud-based system, and, if successful, will reduce the time needed for primary care clinicians to complete and bill for a biopsychosocial assessment. The P-SUD-IS will assess and record family SUD history, personal SUD history, educational history, occupational history, social history, current social supports, and willingness to participate in treatment. Diagnosis and a mental status exam will be conducted using TeleSage’s existing validated DSM-5 self-report diagnostic system (SAGE), which will be integrated into the new P-SUD-IS. Responses to all questions will be used to provide clinicians with detailed electronic reports that can be entered into the client’s EHR. This system is in no way intended to replace the clinician. As a decision-support tool, the P-SUD-IS is intended to help clinicians without specialized training in behavioral health and SUDs use all available resources to complete a biopsychosocial assessment. This study will assess whether underserved primary care clients might be willing and able to complete the P-SUD-IS. Questions will be written at a 5th grade reading level and read aloud using a native text-to- speech application. The client will receive a highly customized electronic report with educational & self-help information as well as links to relevant on-line referral systems. The P-SUD Intake System will generate a report containing actionable information that will make it easier for primary care clinicians to determine if a referral is warranted, and for them to provide the referral documentation that will be most helpful. The new strategy needs to fit within the normal workflow of primary care clinics so as not to cause disruptions. Our goal is for the clinician to be able to look at the report for 2-3 minutes, ask the client specific questions informed by the report, discuss options with the client, finalize the treatment plan, write orders, and bill a sufficient amount for a biopsychosocial assessment to make the whole process economically feasible. By making primary care SUD assessments cost effective and feasible, the P- SUD-IS will have a large impact on the underserved and undiagnosed.

项目摘要 美国的医疗保健服务系统面临着棘手的问题，这些问题越来越多地阻碍了它的发展。 识别和治疗患有SUD的人。初级保健临床医生，我们医疗保健的第一线 交付系统，既没有足够的工具，也没有激励措施，以评估SUD和共同发生的心理健康 紊乱结果是长期诊断不足和治疗不足，以及相关的不良反应。 个人和社会影响。这些缺陷不成比例地影响到得不到充分服务的个人， 已经很难获得卫生保健资源的人口。 我们建议开发和测试一种新的初级保健-SUD-摄入系统（P-SUD-IS）， 通过改变初级保健临床医生的行为和激励客户来解决诊断不足的问题 之前未确诊的SUD寻求帮助。P-SUD-IS将是一个符合HIPAA标准的、用户友好的、 自动化和基于云的系统，如果成功，将减少初级保健临床医生所需的时间 完成生物心理社会评估并收费P-SUD-IS将评估和记录家庭SUD 病史、个人SUD病史、教育史、职业史、社会史、当前社会支持， 并愿意参与治疗。诊断和精神状态检查将使用 TeleSage现有的经过验证的DSM-5自我报告诊断系统（SAGE）将被集成到 新的P-SUD-IS。对所有问题的回答将用于向临床医生提供详细的电子报告 可以输入到客户的EHR中。该系统绝不是为了取代临床医生。作为 作为一种决策支持工具，P-SUD-IS旨在帮助没有接受过行为方面专门培训的临床医生 卫生和SUD使用所有可用资源完成生物心理社会评估。 这项研究将评估服务不足的初级保健客户是否愿意和能够完成 P-SUD-IS问题将在五年级阅读水平写，并使用本地文本大声朗读， 语音应用客户将收到一个高度定制的电子报告与教育和自助 信息以及与相关在线查询系统的链接。 P-SUD进气系统将生成一份报告，其中包含可操作的信息， 初级保健临床医生，以确定是否有必要转诊，并为他们提供转诊 这将是最有帮助的文档。新战略需要适应主要业务的正常工作流程， 护理诊所，以免造成干扰。我们的目标是让临床医生能够在2-3天内查看报告 分钟，询问客户报告中的具体问题，与客户讨论选项，最终确定 治疗计划，写订单，并收取足够的生物心理社会评估费用， 工艺经济可行。通过使初级保健SUD评估具有成本效益和可行性，P- SUD-IS将对服务不足和未确诊的人产生巨大影响。