Use of Patient Buddy Application to Disseminate Knowledge & Prevent Readmission

 描述（由申请人提供）：肝硬化影响超过500万美国人，其中相当大的比例需要经常住院治疗。几项联邦研究表明，由于一致确定的风险因素，可预防的再入院率高得令人无法接受。这些再入院对患者、护理人员和社会都是巨大的负担。然而，传播的措施，以防止在实践中使用的接口，通过移动的健康技术，改善病人-护理人员和临床医生的互动再入院是有限的。Patient Buddy（tm）是由我们的技术合作伙伴CITI开发的符合HIPAA标准的创新智能手机应用程序。该应用程序具有单独的患者和护理人员界面，重点关注影响再入院的几个方面，同时促进沟通和教育。鉴于在预防再住院方面的知识存在巨大差距，我们的中心假设是：患者伙伴，一个移动的患者-护理人员-临床医生界面，将有效减少失代偿性心脏病患者在出院后30天内的再入院率。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：通过使用具有患者和护理人员界面的患者好友应用程序，对传播肝硬化再入院预防的当前知识进行试点和可行性研究。将入组80名受试者（40名中风住院患者和40名护理人员），并在出院时接受患者伙伴培训。该应用程序侧重于患者/护理人员与研究团队之间的日常沟通，基于先前确定的与再入院相关的风险因素。研究小组将使用这些通信采取措施防止再入院。将对30天再入院和患者、护理人员和护士管理人员的意见进行详细分析，以改进应用程序。具体目标2：纳入关键利益相关者（患者、护理人员和病例管理人员）的意见，以改进Patient Buddy应用程序，预防肝硬化再入院。关键利益相关者的输入和在试点研究期间预防的再入院分析将用于更新应用程序，以防止未来研究中的再入院。这项研究将通过加速实施以患者为中心的预防再入院的结果研究来改善健康质量，这将使医疗保健更安全，更负担得起，更有效地防止不必要的重新-通过创新的移动的健康应用程序Patient Buddy，帮助肝硬化患者住院治疗。

 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.