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卫生信息技术（HIT）研究领域的兴趣：通过使用集成数据和知识管理来改善医疗保健决策。社区保健成果推广项目是一种创新模式，用于治疗新墨西哥州农村和服务不足地区的复杂慢性病。该项目培训农村保健专业人员，为农村病人提供与学术保健中心相同水平的护理。该方法基于通过远程医疗基础设施和基于互联网的技术提供的基于病例的学习，以便在社区实践中共同管理患者。在AHRQ （1 UC1 HS015135, PI: S. Arora， MD）的支持下，ECHO项目成功弥合了城市和农村环境在丙型肝炎病毒（HCV）治疗可及性和结果方面的差距，从而为正在进行的国家资助规划铺平了道路。作为这项工作的一部分，我们已经部署了一个名为iHealth的基于互联网的电子治疗记录原型，用于收集数据和生成报告。这个新应用程序的资金将使我们能够为iHealth编写支持标准化数据输入的附加功能，通过警告和自动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项目与其社区实验室合作伙伴之间的自动数据传输。我们进一步建议通过web门户提供这些功能。因此，我们HCV项目的教育和治疗部分将基于广泛可用的技术，因此很容易被其他机构复制。我们会找出使用者的需要，并征求意见，以推广iHealth的应用；运用临床冠军和其他组织策略；利用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了结果，并通过实践支持减少了工作量。评估将由描述创新扩散的理论（Rogers和Orlandi）驱动，并关注利用、提供者的态度和信念，以及过程和结果的变化。iHealth在支持ECHO项目提高农村人口保健质量和安全的使命方面具有巨大潜力，而且可以很容易地用于治疗其他慢性病。

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.