Patient Self Monitoring to Transfer Physical Therapy Exercise from Clinic to Home

描述(申请人提供)：我们的目标是开发一种基于图像的电子健康记录(IBEHR)，以帮助患者在家中传输和复制他们在临床上由物理治疗师(PT)开出的练习。在美国，每年有1700多万(M)患者被诊断出患有可能受益于PT的疾病。坚持家庭锻炼是功能恢复的最重要因素，而运动处方者的反馈是实现患者坚持的最重要因素。然而，在目前的实践中，患者只能在诊所就诊时得到反馈，这可能需要几周的时间。建议的IBEHR将为患者提供实时视觉反馈，将他们在家中每次重复练习时的表现与他们在PT监督下在诊所正确执行练习的记录进行比较。视觉图形向患者展示如何更好地定位他/她的身体和四肢。这样的反馈可能会在锻炼的频率、持续时间和正确性方面提高对治疗方案的依从性，从而促进诊所和家庭之间的护理过渡。IBEHR也是一种远程医疗工具，因为患者可以将家庭锻炼的记录传输到PT，以便快速查看和反馈。IBEHR的第三个好处是改善了PT的医疗决策。在目前的医疗实践中，PT很难确定患者未能按预期恢复的原因。通过记录在家中进行的锻炼，IBEHR提供监测数据，通知PT患者是否坚持规定的锻炼频率或持续时间不佳，患者锻炼进行得不正确，或者PT开出了错误的锻炼处方。我们的具体目标是1)开发IBEHR软件，2)执行设备准确性的阿尔法测试和用户界面易用性的贝塔测试，以及3)对IBEHR的有效性进行初步评估，以提高遵从性。IBEHR对患者自我监测的保健益处是：改善了物理治疗运动从诊所到家庭的转移，增加了对运动处方的遵守，并记录了家庭运动以帮助PT决策。 公共卫生相关性：我们的目标是开发一种基于图像的电子健康记录(IBEHR)，向患者展示如何在家里复制他们的物理治疗师在临床上开出的运动处方。IBEHR还可以记录家庭锻炼课程，供PT审查和反馈。IBEHR对患者自我监测的保健益处是：改善了物理治疗运动从诊所到家庭的转移，增加了对运动处方的遵守，并记录了家庭运动以帮助PT决策。

DESCRIPTION (provided by applicant): Our objective is to develop an image-based electronic health record (IBEHR) to help patients to transfer and reproduce at home the exercises they were prescribed by their physical therapist (PT) in clinic. More than 17 million (M) patients are diagnosed with conditions that may benefit from PT in the U.S. each year. Adherence to home exercise is the most important factor in functional recovery, and feedback from the exercise prescriber is the most important factor in achieving patient adherence. However in current practice the patient only gets feedback at clinic visits which may be weeks apart. The proposed IBEHR will give patients visual feedback in real time comparing their performance at each repetition at home with a recording of themselves performing the exercise correctly in the clinic under the PT's supervision. The visual graphics show the patient how to better position his/her body and extremities. Such feedback is likely to improve adherence with the treatment regimen in terms of frequency, duration, and correctness of exercise, and thus facilitates transition of care between clinic and home. The IBEHR is also a telemedicine tool because the patient can transmit recordings of home exercise to the PT for rapid review and feedback. A third benefit of the IBEHR is to improve health care decision making by the PT. In current medical practice, it is difficult for a PT to determine why a patient fails to recover as expected. By recording the exercise performed at home, the IBEHR provides monitoring data that informs the PT whether the patient adhered poorly to prescribed exercise frequency or duration, the patient performed the exercise incorrectly, or the PT prescribed the wrong exercise. Our Specific Aims are to 1) develop the IBEHR software, 2) perform alpha testing of device accuracy and beta testing of user interface ease of use, and 3) perform preliminary evaluation of the efficacy of the IBEHR to improve adherence. The HEALTH CARE BENEFITS of the IBEHR for patient self monitoring are: improved transfer of physical therapy exercise from clinic to home, increased adherence to the exercise prescription, and recording home exercise to assist PT decision making. PUBLIC HEALTH RELEVANCE: Our objective is to develop an image-based electronic health record (IBEHR) to show patients how to reproduce at home the exercises prescribed by their physical therapist in clinic. The IBEHR can also record home exercise sessions for review by and feedback from the PT. The HEALTH CARE BENEFITS of the IBEHR for patient self monitoring are: improved transfer of physical therapy exercise from clinic to home, increased adherence to the exercise prescription, and recording home exercise to assist PT decision making.