Health Information Technology Center for Education and Research on Therapeutics *

描述(由申请人提供)：拟议的健康信息技术治疗学教育和研究中心(HIT-CERT)将涵盖一系列与HIT对治疗学的影响有关的问题，既建立在我们CERT先前工作的基础上，也涉及重要的新领域。特别是，我们将在利用HIT进行药物监控、药物调节和药物相关临床决策支持方面的工作基础上再接再厉，并确定利用来自药物相关决策支持的信息的新方法，以促进我们对提供者如何应对的了解。我们建议在五年内开展4个研究项目，每个项目都将涉及CERT RFA中确定的一个或多个规划兴趣领域，我们的重点领域是患者安全、工具的开发和增强、医疗保健系统干预以及将其转化为实践或政策。这四项建议将涉及1)利用新技术改善药物监督；2)对电子药物调节工具进行实质性改进；3)使用来自临床决策支持的新数据来源来识别医生水平的变化，并利用这些结果来提高安全性和效率；以及4)直接改善与药物相关的临床决策支持此外，HIT-CERT将建立两个核心来支持这4个项目，这也将增强我们的多学科团队对AHRQ计划工作人员和CERT指导委员会的请求做出快速反应的能力。核心将包括方法/数据资源核心和翻译/传播核心。拟议的HIT-CERT将拥有一些重要的优势：强大而经验丰富的研究团队，在治疗学和HIT领域拥有深厚的专业知识，并长期开展合作活动；跨广泛学科的专业知识，包括医学信息学、医学、护理、药学、药物流行病学、临床流行病学、生物统计学、医疗服务研究、医疗保健政策、以及教育理论和研究；获得广泛的电子健康记录(EHR)、电子处方、临床决策支持相关和临床数据；以及与国家和地区层面的关键利益攸关方建立强大的合作伙伴关系，使我们能够以各种方式改进治疗。我们相信，这项工作将有助于实现美国目前正在进行的大规模HIT投资的一些好处。 与公共卫生相关：美国正在快速采用HIT和电子处方，但同时也面临着巨大的挑战，因为高昂的成本和次优的医疗质量。因此，当务之急是建立我们对HIT一般情况和电子处方如何起作用和不起作用的理解，并提出如何最有效地利用电子处方来提高安全性、质量和效率。特别是，开发利用与药物相关的决策支持的方法将是重要的。

DESCRIPTION (provided by applicant): The proposed Health Information Technology Center for Education and Research on Therapeutics on Health Information Technology (HIT-CERT) will cover a range of issues relating to the impact of HIT on therapeutics, building both on the prior work of our CERT, as well as addressing important new areas. In particular, we will build on our work in leveraging HIT for pharmacosurveillance, medication reconciliation, and medication-related clinical decision support, and identify new ways to utilize information coming from medication-related decision support to advance our understanding of how providers are responding to it. We propose to carry out 4 research projects over a five-year period, each of which will address one or more of the programmatic interest areas identified in the CERT RFA, with our areas of focus being patient safety, development and enhancement of tools, health care system interventions, and translation into practice or policy. The four proposals will involve 1) leveraging new technologies to improve pharmacosurveillance; 2) making substantial improvements to an electronic medication reconciliation tool; 3) using new sources of data from clinical decision support to identify physician-level variation and use these results to improve safety and efficiency; and 4) directly improving medication-related clinical decision support In addition, the HIT-CERT will establish two cores that will support the 4 projects, and which will also enhance our ability to provide rapid response by our multidisciplinary team to requests by the AHRQ program staff and CERT steering committee. The cores will include a methodology/data resources core, and a translation/dissemination core. The proposed HIT-CERT will possess a number of important strengths': a strong and experienced investigator team with deep expertise in the areas of therapeutics and HIT and a long track record of collaborative activities; expertise across a wide range of disciplines, including medical informatics, medicine, nursing, pharmacy, pharmacoepidemiology, clinical epidemiology, biostatistics, health services research, health care policy, and educational theory and research; access to a broad range of electronic health record (EHR), e-prescribing, clinical decision support-related, and clinical data; and strong partnerships with key stakeholders at the national and regional level, to enable us to improve therapeutics in a variety of ways. We believe that this work will help in realizing some of the benefits from the large investment in HIT that the U.S is currently making. PUBLIC HEALTH RELEVANCE: The nation is adopting HIT and electronic prescribing at a rapid pace, and is at the same time faced with enormous challenges because of the high costs and suboptimal care quality. It is therefore imperative that we build our understanding of how HIT in general and electronic prescribing in particular work and do not work, and advance ways it can be leveraged most effectively to improve safety, quality, and efficiency. In particular, developing approaches that leverage medication-related decision support will be important.