Is there a digital divide in Chronic Kidney Disease (CKD)?

描述(由申请人提供)：健康信息技术(IT)提供了新的工具来改善慢性疾病的结果，但很少有IT应用程序是专门为慢性肾脏疾病(CKD)人群设计的，其中包括许多受到“数字鸿沟”不利影响并面临用药差错风险的患者。报名类型：K23导师以病人为本研究事业发展奖。职业发展目标：通过独特的教学课程和新的前瞻性研究计划的执行，培养评估、开发和实施医疗IT解决方案的技能，以提高CKD的护理安全性。研究目的：1)调查CKD患者感知的电子素养与用药差错之间的关系；2)使用基于网站的简单任务列表的绩效评估来评估CKD患者的计算机操作能力与用药差错之间的关系；3)试行一个新的IT原型用药查询系统(MIS)，该系统提供有关CKD中常见的安全使用药物的预防信息。核心研究和人群：慢性肾功能不全队列研究(CRIC)，这是一项全国性的CKD成年参与者队列研究。研究方法：目的1：采用电子健康素养量表(EHEALS)对来自4个审评点(n=1150)的受试者进行调查，了解他们的手机使用情况和对电子健康素养的认知情况。目标2：评估三个CRIC中心(n=195)参与者访问“eCRIC”网站和结构化任务列表的人机交互情况，该列表旨在衡量参与者的计算机熟练程度。评估目标1和2措施与新的用药差错分类方案定义的累积安全威胁程度之间的关联。目标3：评估当地CRIC参与者(n=50)有效使用嵌入个人数字助理(如iPod Touch)的新型管理信息系统应用程序，该应用程序在用户输入实际药物时发出谨慎或不安全的警报，通知用户特定药物的安全性。报告结果的正确性将由研究人员核实。职业发展计划：已经组建了多学科指导团队和课程，以培养Diamantidis博士在医疗保健信息学、患者参与方法和移动技术应用方面的工作知识。指导团队将监督Diamantidis博士的专业发展和对卫生信息技术及其在慢性病人群中的应用的工作理解。这些获得的能力将增强她目前在临床流行病学方面的背景。预期结果：这个以患者为导向的导师研究职业发展奖将帮助Diamantidis博士实现她的近期和长期目标，支持：1)新的和独特的医疗IT研究培训，2)与专家信息学研究人员的多学科合作，3)流行病学高级培训，4)关键初步数据的生成，以促进她过渡到研究独立性，在CKD中实施针对疾病量身定做的医疗IT应用。

DESCRIPTION (provided by applicant): Health information technology (IT) offers new tools to improve outcomes in chronic diseases, yet few IT applications have been designed specifically for the chronic kidney disease (CKD) population, which includes many patients adversely affected by the "Digital Divide" and at risk for medication errors. Application type: K23 Mentored Patient-Oriented Research Career Development Award. Career development aim: Develop skills in the evaluation, development, and implementation of health IT solutions to improve the safety of care in CKD through a unique didactic curriculum and execution of a novel prospective study plan. Study aims: 1) examine the association between surveyed perceived e-literacy and medication errors in individuals with CKD, 2) assess the relationship between functional computer literacy and medication errors in individuals with CKD using performance assessment of a simple website-based task list, and 3) pilot a novel IT prototype medication inquiry system (MIS) which provides precautionary information on the safe usage medications common in CKD. Core study and population: Chronic Renal Insufficiency Cohort (CRIC) study, which is a nationally cohort of adult participants with CKD. Research methods: Aim 1: Survey CRIC participants from 4 CRIC sites (n=1150) at an annual visit regarding their mobile phone usage, and perceived e-health literacy with the validated eHealth Literacy Scale (eHEALS). Aim 2: Assess the human-computer interactions of participants at three CRIC centers (n=195) accessing an "eCRIC' website and a structured assignment list, designed to measure participants' computer proficiency. Evaluate the association between Aims 1 & 2 measures and degree of cumulative threat to safety defined by a novel medication error classification scheme. Aim 3: evaluate local CRIC participants (n = 50) effective use of a novel MIS application embedded on a personal digital assistant-based (e.g. iPod Touch"), which notifies users about the safety of specific medications upon input of their actual medications with CAUTION or NOT SAFE alerts. Correctness of reported results will be verified by study staff. Career development plan: Multidisciplinary mentorship team and curriculum has been assembled to foster Dr. Diamantidis' working knowledge of healthcare informatics, patient engagement methodology, and mobile technology applications. The mentorship team will oversee Dr. Diamantidis in her professional development and acquisition of a working understanding of health IT and its application to chronic disease populations. These acquired competencies will enhance her current background in clinical epidemiology. Anticipated results: This Mentored Patient-Oriented Research Career Development Award will help Dr. Diamantidis achieve her immediate and long term goals by supporting: 1) new and unique training in health IT research, 2) multidisciplinary collaboration with expert informatics researchers, 3) advanced training in epidemiology and 4) the generation of critical preliminary data to facilitate her transition to research independence with a specialized niche in implementation of disease-tailored health IT applications in CKD.