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

描述(由申请者提供)：这个项目特别关注以下健康信息技术(HIT)研究领域：通过使用综合数据和知识管理来改善医疗决策。Echo项目(社区卫生保健成果推广)是在新墨西哥州农村和服务不足地区治疗复杂慢性病的创新模式。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卫生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，以在基于社区的实践中共同管理患者。在AHRQ(1 UC1HS015135，PI：S.Arora，MD)的支持下，Echo项目成功地弥合了城市和农村之间丙型肝炎病毒(HCV)获得机会和治疗结果的差距，从而为正在进行的国家资助计划铺平了道路。作为这一努力的一部分，我们已经部署了一个基于互联网的电子治疗记录的原型，称为iHealth，用于收集数据和生成报告。这一新应用程序的资金将使我们能够为iHealth编程，增加支持标准化数据输入的功能，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，并允许在Project ECHO及其社区实验室合作伙伴之间进行自动数据传输。我们还建议通过门户网站提供这些功能。因此，我们的丙型肝炎病毒计划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。我们将通过确定用户需求和征求反馈；使用临床冠军和其他组织策略；使用Project ECHO的远程学习模式进行iHealth培训；并展示iHealth通过结构化管理改善结果和通过实践支持减少工作量，从而促进iHealth的采用。评估将由描述创新扩散的理论(罗杰斯和奥兰迪)驱动，重点放在利用、提供者的态度和信念以及过程和结果的变化上。IHealth有很大的潜力支持Echo项目的使命，即改善农村人口的医疗保健质量和安全，并可以很容易地适用于其他慢性病。

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.