Project ECHO Hepatitis C Ambulatory Care Quality Improvement in New Mexico throug

描述（由申请人提供）：该项目特别关注以下感兴趣的健康信息技术（HIT）研究领域：通过使用集成数据和知识管理来改善医疗决策。ECHO项目（社区卫生保健成果扩展）是一种创新模式，用于治疗新墨西哥州农村和服务不足地区的复杂慢性病。该项目培训农村卫生保健专业人员，为农村患者提供与学术保健中心相同水平的护理。该方法的基础是通过远程医疗基础设施和基于互联网的技术提供基于案例的学习，以便在社区实践中共同管理患者。在AHRQ（1 UC 1 HS 015135，PI：S. ECHO项目成功地弥合了城乡之间在获得丙型肝炎病毒（HCV）治疗和治疗结果方面的差距，从而为正在进行的国家资助的方案铺平了道路。作为这项工作的一部分，我们已经部署了一个基于互联网的电子治疗记录原型，称为iHealth，用于收集数据和生成报告。这一新应用的资金将使我们能够为iHealth编程额外的功能，支持标准化数据输入，通过警告和自动化治疗算法提高治疗安全性，提供实践支持，促进汇总数据的提取，并允许ECHO项目及其社区实验室合作伙伴之间的自动数据传输。我们还建议通过一个门户网站提供这些功能。因此，我们的HCV项目的教育和治疗部分都将基于广泛可用的技术，因此很容易被其他机构复制。我们将通过以下方式促进采用iHealth：确定用户需求和征求反馈意见;使用临床冠军和其他组织战略;使用ECHO项目的远程学习模式进行iHealth培训;并证明iHealth通过结构化管理改善成果，通过实践支持减少工作量。评价将由描述创新扩散的理论（Rogers和Orlandi）驱动，并侧重于利用率，供应商的态度和信念，以及过程和结果的变化。iHealth在支持ECHO项目的使命以提高农村人口的医疗保健质量和安全方面具有巨大潜力，并可随时用于其他慢性病。

DESCRIPTION (provided by applicant): This project is specifically focused on the following Health Information Technology (HIT) research area of interest: to improve healthcare decision making via the use of integrated data and knowledge management. Project ECHO (Extension for Community Healthcare Outcomes) is an innovative model for treating complex chronic diseases in rural and underserved areas of New Mexico. The Project trains rural healthcare professionals to provide the same level of care to rural patients as they would receive at an academic health center. The approach is based upon case-based learning delivered through a telemedicine infrastructure and Internet-based technologies to co-manage patients in community-based practices. With the support of the AHRQ (1 UC1 HS015135, PI: S. Arora, MD), Project ECHO has successfully bridged the gap in access to and outcomes of treatment for Hepatitis C virus (HCV) between urban and rural settings, thus paving the way for an ongoing State-funded program. As part of this effort, we have already deployed a prototype of an Internet based electronic treatment record called iHealth that is used to collect data and generate reports. Funding of this new application will allow us to program iHealth with additional features that support standardized data entry, improve treatment safety through warnings and automated treatment algorithms, provide practice support, facilitate extraction of aggregate data, and allow automatic data transfers between Project ECHO and its community laboratory partners. We further propose to make these functionalities available through a web portal. Thus, both the educational and treatment components of our HCV program will be based upon widely available technologies and therefore easily replicated by other institutions. We will promote the adoption of iHealth by identifying user needs and soliciting feedback; using clinical champions and other organizational strategies; using Project ECHO's distant learning model for iHealth training; and demonstrating that iHealth improves outcomes through structured management and reduces workload through practice support. The evaluation will be driven by theories describing the diffusion of innovation (Rogers and Orlandi) and focus on utilization, provider attitudes and beliefs, and changes in processes and outcomes. iHealth has significant potential to support Project ECHO's mission to improve health care quality and safety for rural populations and can readily be adopted to other chronic diseases.