权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Tailored Drug Titration through Artificial Intelligence

通过人工智能定制药物滴定

基本信息

批准号：
9341533
负责人：
Gabriela Voskerician
金额：
$ 84.9万
依托单位：
OPTIMA INTEGRATED HEALTH, INC.
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-01 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9341533
关键词：
Admission activity Adoption Adverse effects Affect Age American Artificial Intelligence Blood Pressure Businesses Caring Clinical Clinical Trials Comorbidity Computerized Medical Record Custom Data Disease Effectiveness Emergency Situation Emergency department visit Ensure Ethnic Origin Event Frequencies Gender Generations Goals Health Health Insurance Portability and Accountability Act Healthcare Healthcare Systems Heart failure Hospital Costs Hospitalization Hypersensitivity Hypertension Incidence Intelligence Intervention Studies Laboratories Life Style Logic Measures Medical Medical center Modeling Myocardial Infarction Office Visits Patient Care Patients Pharmaceutical Preparations Physicians Positioning Attribute Preventive care Protocols documentation Quality of Care Quality of life Randomized Randomized Clinical Trials Risk Risk stratification San Francisco Schedule Secure Site Stroke Surveys Symptoms System Technology Time Titrations Update Visit arm base blood pressure reduction blood pressure regulation clinical efficacy cloud based commercial application computerized data processing cost design health care delivery health care service health data hypertension treatment improved innovative technologies medication compliance novel patient stratification primary outcome response scale up secondary outcome success tool web services

项目摘要

Optima Integrated Health Inc. (Optima) proposes to demonstrate the clinical efficacy of the decision support technology for medication treatment optimization it validated in a pilot clinical trial, optima4BP. optima4BP is designed as a physician decision/action support aid in timely and safely optimizing medication treatment independent of in-office visits, for patients with uncontrolled hypertension (HTN). optima4BP is designed to reduce preventable hospitalizations and the associated incidence of stroke, heart failure (HF) or myocardial infarction (MI) events resulting from high blood pressure (BP) above goal. Uncontrolled HTN affects 34 million Americans. The cost of HTN-associated hospitalizations is $113 billion, or 15% of all hospital costs, with >135 million Emergency Dptm. (ED) visits. optima4BP will improve the quality of life for uncontrolled HTN patients, and reduce this massive burden on the US healthcare system. Our long term objective is to help drive the transformation from the reactive pay-for-service healthcare paradigm to one that emphasizes preventative care through personalized health surveillance, assessment, and action via timely and safely optimized medication treatment. Our specific aims include: Aim (1) demonstrating the efficacy of optima4BP in a randomized clinical trial (n=300 patients) deployed at UC San Francisco Medical Center. Patients will be randomized to an enhanced care (EC) arm or an optima4BP arm (O4BP). All patients will use Omron10 BP arm cuff to remotely measure their BP. For the patients in the EC arm, physicians will be provided with a monthly summary of the Omron10 data. For patients in the O4BP arm, aside from the BP monthly summary, physicians will receive (a) a risk stratified patient roster, (b) next step actions in medication optimization for each patient, and (c) access to optima4BP's secure web-service medication treatment modeling to investigate how changing current patient data could affect medication choice (e.g., change in medication choice if BP goal is lowered). We will then examine the BP value reduction between arms (success:>7 mmHg decreased systolic; >4 mmHg decreased diastolic of O4BP vs. EC), along with secondary outcomes between O4BP and EC: medication treatment action frequency; ED admissions due to HTN-related symptoms and associated hospitalizations for stroke, HF or MI; and overall cost of HTN management. Aim (2) optima4BP data processing steps will be optimized to scale-up its capability to >1000/day patient cases processing power. 3 specific optimization processing tools will be developed: Optima Extract, Transform, and Load (OETL); Optima Survey Generator (OSG), and Optima Message Builder (OMB). OETL will provide streamlined scheduling logic to extracting data from Epic® EMR (electronic medical record), optimize data mapping scripts within optima4BP, and optimize data uploading protocols. OSG will optimize the current generation protocol for patient surveys, patient response, and assignment of patient responses to specific processing modules. OMB will ensure streamlined scheduling of risk stratification updates and scheduled delivery to physician In-Basket messaging system within Epic® EHR.

Optima Integrated Health Inc.（Optima）建议证明决策支持的临床有效性该技术用于药物治疗优化，在试点临床试验optima 4 BP中得到验证。Optima 4 BP是设计为医生决策/行动支持辅助工具，以及时、安全地优化药物治疗独立于门诊访视，用于不受控制的高血压（HTN）患者。optima 4 BP旨在减少可预防的住院治疗和中风、心力衰竭（HF）或心肌梗死的相关发病率高血压（BP）高于目标导致的梗死（MI）事件。不受控制的HTN影响3400万人美国人HTN相关的住院费用为1130亿美元，占所有医院费用的15%，其中>135 百万紧急救护车(ED)探访optima 4 BP将改善不受控制的HTN患者的生活质量，减轻美国医疗系统的巨大负担。我们的长期目标是帮助推动从被动的按服务付费的医疗模式转变为强调预防性护理的模式通过个性化的健康监测、评估和及时、安全的优化用药采取行动，治疗我们的具体目的包括：目的（1）证明Optima 4 BP在随机临床试验中的有效性。在UC San弗朗西斯科医学中心开展的试验（n=300例患者）。患者将被随机分配至加强护理（EC）组或Optima 4 BP组（O 4 BP）。所有患者将使用Omron 10 BP臂袖带远程测量他们的血压。对于EC组的患者，将向医生提供每月一次的 Omron 10数据。对于O 4 BP组的患者，除了BP每月总结外，医生还将收到（a）风险分层的患者名册，（B）针对每个患者的药物优化的下一步行动，以及（c）访问 optima 4 BP的安全网络服务药物治疗模型，以调查如何改变当前患者数据可能影响药物选择（例如，如果血压目标降低，则改变药物选择）。然后我们将检查臂间血压值下降（成功：收缩压下降>7 mmHg;收缩压下降>4 mmHg O 4 BP与EC的舒张压），沿着O 4 BP与EC之间的次要结局：药物治疗行动频率;因HTN相关症状和卒中、HF相关住院而导致的艾德入院或MI;以及HTN管理的总体成本。目的（2）优化optima 4 BP数据处理步骤，将其处理能力扩大到>1000例/天。3种特定的优化处理工具将开发：Optima提取、转换和加载（OETL）; Optima调查生成器（OSG）和Optima 消息生成器（OMB）。OETL将提供简化的调度逻辑，以从Epic® EMR中提取数据（电子病历），优化optima 4 BP内的数据映射脚本，优化数据上传协议. OSG将优化患者调查、患者响应和将患者响应分配给特定处理模块。管理和预算办公室将确保简化 Epic® EHR中的风险分层更新和向医生In-Basket消息传递系统的计划交付。