The Virtual Patient for Improving Quality of Care in Primary Healthcare

项目摘要 虽然创伤性生活经历和心理健康之间的关系一直很好- 新的研究表明，创伤性生活事件对身体的影响 健康这些研究直接证明了身体健康问题的积极风险 由于创伤事件以及通过创伤后应激障碍（PTSD）介导， 萧条初级卫生保健是卫生保健系统的主要切入点， 与创伤有关的精神疾病然而，通常的初级卫生保健，特别是 弱势族裔群体，由于诊断不足和 治疗 在难民创伤（HPRT）在马萨诸塞州总医院/哈佛哈佛计划 医学院、卡罗林斯卡医学院（KI）和林恩社区卫生中心（LCHC） 通过这笔赠款将是第一个开发基于计算机的模拟训练或 虚拟病人（VP），用于识别和治疗创伤相关的心理健康， 健康失调这项赠款特别值得注意的是，它侧重于医疗/心理健康， 照顾低收入、文化多样、英语水平低的患者。 该基金的主要研究目标包括：（1）由HPRT在LCHC开发VP原型 和KI，可以有效地培训初级保健提供者对健康和 来自不同文化背景的创伤性PHC患者的心理健康问题;（2） 初步测试VP对提高LEP患者护理质量的影响;（3） 以电子方式将VP培训整合到LCHC设置中，供所有LCHC访问 （4）制定全州和全国传播和研究的指导方针， VP的推广是HIT的一项重大创新。 这笔赠款是对受贫困影响社区初级保健的一项重大贡献， 暴力作为HIT创新的VP可以提供可持续的培训和护理质量 改善弱势患者及其初级保健提供者的状况。

PROJECT SUMMARY While the relationship between traumatic life experiences and mental health has been well- established, new research studies are revealing the impact of traumatic life events on physical health. These studies are demonstrating the positive risk for physical health problems directly due to trauma events as well as mediated through posttraumatic stress disorder (PTSD) and depression. Primary health care (PHC) is the primary entry point to the health care system for trauma related mental health disorders. Yet, the usual primary health care, especially for disadvantaged ethnic groups, may be less than optimal due to under-diagnosis and under- treatment. The Harvard Program in Refugee Trauma (HPRT) at Massachusetts General Hospital/Harvard Medical School, the Karolinska Institutet (KI), and the Lynn Community Health Center (LCHC) through this grant will be one of the first to develop a computer-based simulation training or Virtual Patient (VP) for the identification and treatment of trauma-related mental health and health disorders. This grant is especially noteworthy for its focus on the medical/mental health care of low-income, culturally diverse patients with low English proficiency (LEP). Major research goals of this grant include: (1) development of a VP prototype at LCHC by HPRT and KI that can effectively train PHC providers on the diagnosis and treatment of health and mental health problems in traumatized PHC patients from culturally diverse backgrounds; (2) preliminary testing of impact of the VP on improving the quality of care of LEP patients; (3) electronically integrating the VP training into the LCHC settings for access by all LCHC providers; (4) establishing guidelines for state-wide and national dissemination and research on the generalization of the VP as a major HIT innovation. This grant represents a major contribution in the PHC of communities affected by poverty and violence. The VP as a HIT innovation can provide sustainable training and quality of care improvement for disadvantaged patients and their PHC providers.