The Virtual Patient for Improving Quality of Care in Primary Healthcare

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DESCRIPTION (provided by applicant): While the relationship between traumatic life experiences and mental health has been well- established, new research studies are revealing the impact of traumatic life events on physical health. These studies are demonstrating the positive risk for physical health problems directly due to trauma events as well as mediated through posttraumatic stress disorder (PTSD) and depression. Primary health care (PHC) is the primary entry point to the health care system for trauma related mental health disorders. Yet, the usual primary health care, especially for disadvantaged ethnic groups, may be less than optimal due to under-diagnosis and under- treatment. The Harvard Program in Refugee Trauma (HPRT) at Massachusetts General Hospital/Harvard Medical School, the Karolinska Institute (KI), and the Lynn Community Health Center (LCHC) through this grant will be one of the first to develop a computer-based simulation training or Virtual Patient (VP) for the identification and treatment of trauma-related mental health and health disorders. This grant is especially noteworthy for its focus on the medical/mental health care of low-income, culturally diverse patients with low English proficiency (LEP). Major research goals of this grant include: (1) development of a VP prototype at LCHC by HPRT and KI that can effectively train PHC providers on the diagnosis and treatment of health and mental health problems in traumatized PHC patients from culturally diverse backgrounds; (2) preliminary testing of impact of the VP on improving the quality of care of LEP patients; (3) electronically integrating the VP training into the LCHC settings for access by all LCHC providers; (4) establishing guidelines for state-wide and national dissemination and research on the generalization of the VP as a major HIT innovation. This grant represents a major contribution in the PHC of communities affected by poverty and violence. The VP as a HIT innovation can provide sustainable training and quality of care improvement for disadvantaged patients and their PHC providers. PUBLIC HEALTH RELEVANCE: The Harvard Program in Refugee Trauma (HPRT) of Massachusetts General Hospital/ Harvard Medical School, the Karolinska Institute and the Lynn Community Health Center are preparing this grant to develop a computer-based patient simulation or Virtual Patient (VP) for use in primary health care (PHC) settings. This will be the first use of VP in PHC to aid in the identification and treatment of trauma-related health and mental health problems in highly traumatized, culturally diverse patients. This VP prototype will provide sustainable Health Information Technology (HIT) training and clinical quality of care improvement for disadvantaged communities and their PHC providers.