Computerized Decision Support for Pediatric Gastroenterology

儿科胃肠病学的计算机化决策支持

• 批准号: 8700066
• 负责人: William Estus Bennett
• 金额: $ 17.1万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-08 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700066
• 关键词: Adherence; Ambulatory Care Facilities; Automation; Awareness; Caring; Child health care; Childhood; Chronically Ill; Clinical; Clinical Decision Support Systems; Clinical Research; Collaborations; Computer Systems; Constipation; Data; Decision Support Systems; Diagnostic tests; Environment; Evidence Based Medicine; Gastroenterology; Goals; Guideline Adherence; Guidelines; Health; Health Services; Health Services Research; Immersion Investigative Technique; Informatics; Knowledge; Measures; Medical; Medical Informatics; Mentors; Mind; Morbidity - disease rate; Outcome; Outpatients; Patients; Physicians; Primary Health Care; Process; Provider; Public Health; Publishing; Quality of Care; Recommendation; Research; Research Personnel; Resources; Risk; Solutions; System; Testing; Time; Training; Translating; Translations; Variant; Work; Writing; career; career development; clinical practice; computerized; cost; design; efficacy testing; evidence base; evidence based guidelines; experience; health care quality; improved; information gathering; medical specialties; mortality; next generation; novel; primary care setting; public health relevance; success; uptake; wasting

DESCRIPTION (provided by applicant): Evidence-based medicine penetrates poorly into clinical practice, resulting in a large amount of wasted resources and increased morbidity and mortality from inappropriate or inefficient medical care. Computerized decision support has been shown to substantially improve this process in multiple venues. Preliminary work has shown that pediatric gastroenterology as a specialty shows substantial variation in care nationally, indicating the need for measures to aid providers in the use of evidence-based guidelines. Our research group has developed a large, robust computerized decision support system for use in pediatric primary care: the Child Health Improvement through Computerized Automation (CHICA). The primary goal of this application is to adapt this system for use in a pediatric subspecialty setting (CHICA-GI) and study its effects on adherence to evidence-based medicine and on clinical outcomes. The hypothesis of this application is that the introduction of an evidence-based computerized decision support system into pediatric gastroenterology care will improve adherence to guidelines, as well as general health outcomes. This hypothesis will be tested by accomplishing the following specific aims: Gain knowledge and expertise about the CHICA system currently utilized in the primary care setting by modifying the system to support a pediatric gastroenterology guideline for constipation in a primary care setting (Aim 1). Build a new version of the CHICA system for use in the pediatric gastroenterology outpatient clinic setting (CHICA-GI) (Aim 2). Modify the newly built CHICA-GI system to support multiple pediatric gastroenterology guidelines and determine if the CHICA-GI CDSS improves adherence to the three evidence-based guidelines as well as patient level outcomes (Aim 3). Furthermore, the career development goals of this application include intensive training in medical informatics, as well as immersion in a mentoring environment surrounded by established physician-investigators in health services, informatics, and pediatric gastroenterology. At the end of this project, I will have built and intensively studied a unique computerized decision support system in pediatric gastroenterology and will be poised to create the next generation of systems necessary to bridge the gap between clinical practice and research.

描述（由申请人提供）：循证医学在临床实践中的渗透性较差，导致大量资源浪费，不适当或低效的医疗护理导致发病率和死亡率增加。计算机化的决策支持已被证明在多个地点大大改善了这一过程。初步工作表明，儿科胃肠病学作为一个专业，在全国范围内的护理显示出很大的差异，这表明需要采取措施，以帮助供应商使用循证指南。我们的研究小组开发了一个大型的，强大的计算机化决策支持系统，用于儿科初级保健：通过计算机自动化改善儿童健康（CHICA）。本申请的主要目标是调整该系统用于儿科亚专业环境（CHICA-GI），并研究其对循证医学依从性和临床结局的影响。本申请的假设是，将循证计算机化决策支持系统引入儿科胃肠病护理将改善对指南的依从性以及一般健康结局。将通过实现以下特定目标来检验这一假设：通过修改CHICA系统以支持初级保健环境中便秘的儿科胃肠病学指南，获得有关目前在初级保健环境中使用的CHICA系统的知识和专业知识（目标1）。构建新版CHICA系统用于儿科胃肠病门诊（CHICA-GI）（目标2）。修改新建的CHICA-GI系统，以支持多个儿科胃肠病学指南，并确定CHICA-GI CDSS是否改善了对三个循证指南的依从性以及患者水平结局（目标3）。此外，该应用程序的职业发展目标包括医学信息学的强化培训，以及沉浸在由健康服务，信息学和儿科胃肠病学的既定医生调查员包围的指导环境中。在这个项目结束时，我将建立和深入研究一个独特的计算机化的决策支持系统在儿科胃肠病学，并将准备创建下一代的系统，必要的桥梁之间的差距差距临床实践和研究。