An eHealth solution for posttraumatic stress and pain screening integrated in pediatric injury care

将创伤后应激和疼痛筛查纳入儿科损伤护理的电子健康解决方案

• 批准号: 9410127
• 负责人: Nancy Kassam-Adams
• 金额: $ 71.58万
• 依托单位: RADIANT CREATIVE GROUP, LLC
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410127
• 关键词: Accident and Emergency department; Accountability; Acute; Address; Admission activity; Affect; Caring; Child; Child Mortality; Child health care; Childhood; Childhood Injury; Chronic Disease; Clinical Research; Computer software; Data; Development; Economics; Evaluation; Face; Funding; Future; Goals; Health; Health Personnel; Health system; Healthcare; Healthcare Systems; Hospital Departments; Hospitals; Impairment; Incentives; Individual; Industry; Information Systems; Injury; Interview; Joints; Knowledge; Managed Care; Measures; Medicaid; Medical; Modality; Outcome; Pain; Parents; Patient Self-Report; Patient-Focused Outcomes; Patients; Pediatric Hospitals; Pennsylvania; Persistent pain; Phase; Philadelphia; Predictive Analytics; Production; Prospective Studies; Provider; Recovery; Recovery of Function; Recruitment Activity; Reporting; Research; Resources; Risk; School-Age Population; Screening Result; Sickle Cell Anemia; Site; Symptoms; System; Systems Development; Technology Transfer; Testing; Time; Trauma; Trauma patient; United States; United States Health Resources and Services Administration; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Update; Work; base; beneficiary; clinically relevant; cohort; commercialization; cost; design; digital; disability; eHealth; experience; follow-up; functional outcomes; game development; health information technology; health related quality of life; high risk; improved; improved outcome; injured; interest; intervention program; novel; pediatric patients; pediatric trauma; post-traumatic stress; preference; product development; programs; prototype; screening; stress symptom; tool; trauma care; treatment as usual; usability

ABSTRACT Pediatric injury is the leading cause of child mortality and acquired disability in the United States, affecting 20 million children annually. Among school age children alone, more than 2 million are treated in Emergency Department or admitted to the hospital annually for injury, incurring billions in medical and work-loss costs each year. After hospital discharge, many injured children experience pain that is not well-controlled, and approximately 1 in 6 develops persistent posttraumatic stress symptoms (PTSS). Both pain and PTSS have been shown to be associated with health and functional outcomes following injury. Health systems face increasing economic accountability for short- and long-term patient outcomes, but few have the ability to routinely screen for indicators of modifiable factors for poor recovery in injured pediatric patients after discharge from the hospital or emergency department, hampering follow-up care and impairing optimal outcomes. There is currently no practical, validated means to screen children, post-discharge, for pain, PTSS and functional recovery in a timely fashion and to make these data actionable to healthcare system stakeholders or to beneficiaries such as parents. We propose a novel, validated child self-report screening system that is delivered to pediatric trauma patients in a child-friendly modality, scored in real time, and integrated with external healthcare IT systems. The system addresses an urgent unmet need, and will transform pediatric trauma care by connecting screening results to follow-up care and predictive analytics to improve injury outcomes. Building on Phase I efforts that demonstrated the system’s feasibility, usability, subjective appeal and commercial potential, and learned from key stakeholders, this Phase II project continues system development and commercialization, with the active involvement of a potential customer. The integrated digital screening system takes advantage of advances in e-Health and developmentally-appropriate user engagement strategies, as well as a shifting economic landscape that provides health systems with incentives for optimizing short- and long-term patient outcomes and achieving meaningful use of health information technology. The proposed technology-transfer and commercialization effort is supported by a decade-long strong industry/academic technology transfer partnership that is ideally suited for pediatric trauma care transformation.

抽象的 儿童伤害是美国儿童死亡和后天残疾的主要原因，影响了 20 名儿童 每年 10 万名儿童。仅在学龄儿童中，就有超过 200 万人接受紧急治疗 每年因受伤入院或入院，造成数十亿美元的医疗和工作损失费用 每年。出院后，许多受伤儿童会出现无法很好控制的疼痛，并且 大约六分之一的人会出现持续性创伤后应激症状（PTSS）。疼痛和 PTSS 都有 已被证明与受伤后的健康和功能结果相关。 卫生系统面临着对短期和长期患者结果日益增加的经济责任，但很少有 有能力定期筛查受伤儿科恢复不良的可改变因素的指标 患者出院或急诊室后，妨碍后续护理并损害 最佳结果。目前还没有实用的、经过验证的方法来筛查儿童出院后的疼痛、 及时进行 PTSS 和功能恢复，并使这些数据可用于医疗保健系统 利益相关者或受益人，例如父母。 我们提出了一种新颖的、经过验证的儿童自我报告筛查系统，该系统可提供给儿科创伤患者 以儿童友好的方式进行，实时评分，并与外部医疗保健 IT 系统集成。系统 解决迫切的未满足需求，并将通过将筛查结果与 后续护理和预测分析以改善伤害结果。在第一阶段努力的基础上 论证了系统的可行性、可用性、主观吸引力和商业潜力，并从中学习 主要利益相关者，该二期项目继续系统开发和商业化，积极 潜在客户的参与。集成数字放映系统利用了先进技术 电子医疗和适合发展的用户参与策略，以及不断变化的经济 为卫生系统提供优化短期和长期患者治疗结果的激励措施 并实现卫生信息技术的有效利用。拟议的技术转让和 商业化努力得到了长达十年的强大行业/学术技术转让的支持 非常适合儿科创伤护理转型的合作伙伴关系。