Use of Patient Buddy Application to Disseminate Knowledge & Prevent Readmission

 描述(申请人提供)：有500多万美国人患有肝硬变，其中很大一部分需要经常住院治疗。几项联邦研究表明，由于一致确定的危险因素，肝硬变患者中可预防的再住院率高得令人无法接受。这些重新入院给患者、照顾者和社会带来了巨大的负担。然而，通过移动卫生技术改善患者-护理者和临床医生互动的界面，在实践中防止再次入院的措施的传播是有限的。Patient Buddy(Tm)是我们的技术合作伙伴花旗开发的符合HIPAA标准的创新智能手机应用程序。这款应用程序有单独的患者和护理者界面，专注于影响重新入院的几个方面，同时促进沟通和教育。鉴于在预防再次住院方面知识的巨大差距，我们的中心假设是：患者伙伴，一个流动的患者-护理者-临床医生界面，将有效地减少失代偿期肝硬变患者出院30天内的再入院。我们建议使用以下两个具体目标来测试这一点：具体目标1：通过使用带有患者和照顾者界面的Patient Buddy App进行传播当前肝硬变再入院预防知识的试点和可行性研究。80名受试者(40名肝硬变住院患者和40名护理人员)将被招募，并在出院时接受患者巴迪的培训。该应用程序专注于患者/护理人员与研究团队之间的日常交流，基于先前确定的与再次入院相关的风险因素。研究小组将采取措施，防止使用这些通信再次入院。将对患者、护理员和护士经理30天的重新入院和投入进行详细分析，以改进应用程序。具体目标2：纳入关键利益相关者(患者、照顾者和病例管理人员)的意见，以改进患者伙伴应用程序，以预防肝硬变患者再次住院。主要利益相关者的意见和在试点研究期间防止再次住院的分析将用于在未来的研究中更新预防再次住院的App。这项研究将通过加快实施以患者为中心的预防再次住院结果研究来提高医疗质量，这将通过创新的移动医疗应用程序Patient Buddy防止肝硬变患者不必要的再次住院，使医疗保健更安全、更负担得起和更有效。

 DESCRIPTION (provided by applicant): Cirrhosis affects more than 5 million Americans, of whom a substantial percentage requires frequent hospitalization. Several federally studies have demonstrated an unacceptably high rate of preventable readmission in cirrhotics due to consistently identified risk factors. These readmissions are a tremendous burden on patients, caregivers and society. However, the dissemination of measures to prevent readmission in practice using interfaces that improve patient-caregiver and clinician interaction through mobile health technology is limited. Patient Buddy(tm) is a HIPAA-compliant innovative smartphone application developed by our technology partner CITI. This App has separate patient and caregiver interfaces focused on several aspects that impacting readmissions while promoting communication and education. Given this immense gap in knowledge in the prevention of re-hospitalization, our central hypothesis is: Patient Buddy, a mobile patient-caregiver-clinician interface, will effectively reduce readmissions in decompensated cirrhotic patients within 30 days of discharge. We propose to test this using the following two specific aims: Specific aim 1: To perform a pilot and feasibility study of disseminating current knowledge of readmission prevention in cirrhosis by using the Patient Buddy App with patient and caregiver interfaces. Eighty subjects (40 cirrhotic inpatients and 40 caregivers) will be enrolled and trained on the Patient Buddy at discharge. The App focuses on daily communication between patient/caregivers and the study team based on previously identified risk factors associated with readmission. The study team will initiate measures to prevent readmission using these communications. A detailed analysis of 30-day readmissions and input of the patients, caregivers and nurse manager will be performed to improve the App. Specific aim 2: To incorporate the opinion of key stakeholders (patients, caregivers and case managers) towards improving the Patient Buddy App in the prevention of readmission in cirrhosis. The input of the key stakeholders and the analysis of readmissions prevented during the pilot study will be used to update the App for preventing readmissions in future studies This research will improve health quality by accelerating implementation of patient- centered outcomes research on prevention of readmissions, which will make health care safer and more affordable and efficient by preventing unnecessary re-hospitalizations in cirrhosis through an innovative mobile health Application, Patient Buddy.