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Pediatric Patient Engagement as a Criteria for Meaningful Use Stage 3

儿科患者参与作为有意义使用第 3 阶段的标准

基本信息

批准号：
8642460
负责人：
Alexander Gabriel Fiks
金额：
$ 48.79万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2015-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8642460
关键词：
Pediatric Patient Engagement Criteria Meaningful

项目摘要

PROJECT SUMMARY/ABSTRACT The federal government has allocated $27 billion to fund a staged program to foster the meaningful use of electronic health records. Stage 3 of the meaningful use program (MU3) prioritizes that families have the ability to submit patient-generated health information to improve health care performance on priority conditions and improve engagement in care. Patient portals, online healthcare applications that allow patients to interact and communicate with their healthcare providers, offer an ideal tool to achieve these goals, but the feasibility of using portals to achieve this goal and the impact of use on clinical care across diverse pediatric practice settings has not been established. Focusing on asthma, an AHRQ priority condition, in three AHRQ priority populations, children, low income, and special health care needs, this protocol will directly address these critical knowledge gaps in order to inform MU3 policy and practice implementation. Drawing from implementation science, this study evaluates the determinants of implementation success, implementation outcomes, and health care outcomes resulting from implementing an asthma portal in a national, AHRQ-funded, Center for Pediatric Practice-Based Research and Learning. Technically, the portal will be implemented with 2 innovative approaches that facilitate rapid cycle evaluation in multiple electronic health record systems. Although many patient portals are simple vehicles for transferring information about upcoming appointments, test results or laboratory findings, the asthma portal in this project, already developed and tested through a rigorous user-centered design process, extends this basic functionality to provide asthma education, collect patient-reported outcomes, evaluate medication use and side effects, and track parents' preferences and goals. Policy relevance of this research will be assured through the collaboration of The Children's Hospital of Philadelphia's PolicyLab, which has particular expertise in synthesizing research findings to inform policy, and the AAP's Child Health Informatics Center, which already is actively engaged with the Office of the National Coordinator for Health Information Technology in establishing guidelines for MU in pediatrics and will employ the full dissemination capabilities of the AAP to ensure that findings reach all appropriate stakeholders. Both groups have informed the proposal's 3 specific aims that utilize mixed methods: (1) To study the feasibility for pediatric primary care practices of using an EHR-linked portal to provide education and enable families to communicate treatment concerns and goals and report symptom control, medication use and side effects for children with asthma; (2) For a subset of children with poorly controlled asthma or medication side effects, to assess the impact on asthma management resulting from gathering data from families through the portal and sharing them with the primary care clinical team; and, (3) To describe barriers and solutions to improve the adoption, sustainability, and impact on clinical care of implementing portals across practice settings.

项目总结/摘要联邦政府已经拨款270亿美元资助一个分阶段的计划，以促进有意义地使用电子健康记录。有意义的使用计划（MU 3）的第三阶段优先考虑家庭拥有能够提交患者生成的健康信息，以改善优先条件下的医疗保健绩效并改善护理参与度。患者门户网站，允许患者互动的在线医疗保健应用程序并与他们的医疗保健提供者沟通，提供一个理想的工具来实现这些目标，但可行性，使用门户网站来实现这一目标，以及在不同儿科实践中使用门户网站对临床护理的影响设置尚未建立。关注哮喘，这是AHRQ的一个优先条件，在三个AHRQ优先条件中人口、儿童、低收入和特殊卫生保健需求，本议定书将直接解决这些问题。关键的知识差距，以便为MU 3政策和实践的实施提供信息。从实施科学的角度，本研究评估了实施成功的决定因素，实施结果，以及实施哮喘门户网站在国家，AHRQ资助，儿科实践为基础的研究和学习中心。严格来说传送门将采用2种创新方法，促进在多个电子系统中进行快速周期评价健康记录系统。虽然许多患者门户网站是简单的工具，用于传输有关即将到来的预约，测试结果或实验室发现，该项目中的哮喘门户，已经开发并通过严格的以用户为中心的设计过程进行测试，扩展了这一基本功能，教育，收集患者报告的结果，评估药物使用和副作用，并跟踪父母的偏好和目标。这项研究的政策相关性将通过儿童医院的合作得到保证。费城的政策实验室在综合研究结果以制定政策方面具有特殊的专业知识， AAP的儿童健康信息学中心，该中心已经积极与国家卫生部办公室合作，卫生信息技术协调员，负责制定儿科MU指南，并将雇用年度行动计划的全面传播能力，以确保所有相关利益攸关方了解调查结果。两小组已告知该提案的3个具体目标，利用混合方法：（1）研究使用EHR链接门户网站提供教育并使家庭能够沟通治疗问题和目标，并报告症状控制，药物使用和副作用，哮喘儿童;（2）对于哮喘控制不佳或药物副作用的儿童，评估通过门户网站从家庭收集数据对哮喘管理的影响，与初级保健临床团队分享;以及，（3）描述障碍和解决方案，以改善采用，可持续性，以及在实践环境中实施门户网站对临床护理的影响。