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Modeling and Optimization of Clinical Processes Using EHR Data

使用 EHR 数据对临床流程进行建模和优化

基本信息

批准号：
9765376
负责人：
Michelle Hribar
金额：
$ 22.41万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-20 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9765376
关键词：
Address Ambulatory Care Facilities Area Award Classification Client satisfaction Clinic Clinical Computer software Data Data Collection Electronic Health Record Engineering Environment Event Eye Future Goals Health Care Costs Health Personnel Health Sciences Hospitals Informatics Inpatients Length Length of Stay Manuals Medical Mentors Mentorship Methods Modeling Monitor Motion Movement Operations Research Operative Surgical Procedures Ophthalmology Oregon Outcome Outpatients Paper Patient Schedules Patient imaging Patients Phase Phase Transition Physicians Positioning Attribute Probability Process Productivity Provider Recovery Research Resources Schedule Source System Techniques Testing Time Time and Motion Studies Training United States Universities Wait Time barrier to care base biomedical informatics computer science demographics density design electronic data experience experimental study health care delivery hospital bed improved mathematical sciences medical specialties member models and simulation novel open source patient safety pressure programs simulation tool

项目摘要

DESCRIPTION (provided by applicant): The goal of this K99/R00 award is to apply methods from biomedical informatics, operations research, and computer science to develop, implement, and evaluate stimulation and optimization tools for improving clinical processes. This is an important topic because electronic health record (EHR) systems have potential to improve quality and cost of health care, yet providers have raised concerns that EHR implementation has negatively impacted real-world productivity and efficiency. Methods for improving workflow based on automated time-motion data collection will have significant real-world impact. This proposal involves two phases: (A) K99 training and mentored research phase, which will include training in advanced operations research and analytics techniques at Oregon Health & Science University (OHSU) and Portland State University. Under the mentorship of two experienced informaticians and clinicians, a statistician, and a systems engineer, this training will be applie to research in improving clinical workflows. The K99 phase of research will focus on studying ophthalmology outpatient clinic workflows and the first two Specific Aims of the overall project: (SA#1) Develop tools for automated time-motion workflow data collection tools based on EHR timestamps and indoor positioning systems and (SA#2) Create simulation models to improve the efficiency of clinical workflow and validate these models by testing them in ophthalmology outpatient clinics. Ophthalmology will be an ideal clinical domain for performing these initial workflow studies because it is a fast-paced ambulatory specialty that includes medical and surgical patients, imaging tests, multiple examination stages (e.g., before & after eye dilation), and multiple ancillary staff members (e.g., technicians, photographers). (B) R00 research phase and transition to independence. The R00 phase of research will focus on the third Specific Aim of the overall project: (SA#3) Develop, implement, and evaluate data collection, simulation, and modeling techniques to broader inpatient and outpatient medical domains. This will generalize methods from the mentored project phase by collecting EHR data (e.g., surgery type, length of inpatient stay, demographics) to create probability density functions representing patient demand for resources. These data will be used to develop simulation models for different scheduling strategies based on patient classifications, and to evaluate them in the clinical setting. This project will benefit from a PI who has a strong background in mathematics and computer science, from an outstanding collaborative team of mentors with complementary experience across all areas of the proposed project, and from an outstanding academic informatics environment at OHSU.

该K99/R 00奖项的目标是应用生物医学信息学，运筹学和计算机科学的方法来开发，实施和评估用于改善临床流程的刺激和优化工具。这是一个重要的话题，因为电子健康记录（EHR）系统有潜力提高医疗保健的质量和成本，但供应商已经提出了EHR实施对现实世界的生产力和效率产生负面影响的担忧。基于自动时间-运动数据收集的工作流程改进方法将对现实世界产生重大影响。该提案涉及两个阶段：（A）K99培训和指导研究阶段，其中将包括在俄勒冈州健康与科学大学（OHSU）和波特兰州立大学进行高级运筹学和分析技术培训。在两名经验丰富的信息学家和临床医生，一名统计学家和一名系统工程师的指导下，这项培训将应用于改善临床工作流程的研究。K99研究阶段将重点研究眼科门诊工作流程和整个项目的前两个具体目标：（SA#1）开发基于EHR时间戳和室内定位系统的自动时间-运动工作流程数据收集工具，以及（SA#2）创建模拟模型以提高临床工作流程的效率，并通过在眼科门诊中测试这些模型来验证这些模型。眼科将是进行这些初始工作流程研究的理想临床领域，因为它是一个快节奏的门诊专科，包括内科和外科患者、成像测试、多个检查阶段（例如，在眼睛扩张之前和之后），以及多个辅助工作人员（例如，技术人员、摄影师）。(B)R 00研究阶段和向独立过渡。研究的R 00阶段将集中在整个项目的第三个具体目标：（SA#3）开发，实施和评估数据收集，模拟和建模技术，以更广泛的住院和门诊医疗领域。这将通过收集EHR数据（例如，手术类型、住院时间长度、人口统计学）来创建表示患者对资源的需求的概率密度函数。这些数据将用于开发基于患者分类的不同调度策略的模拟模型，并在临床环境中对其进行评估。该项目将受益于PI谁拥有强大的数学和计算机科学背景，从一个优秀的合作团队的导师与互补的经验在所有领域的拟议项目，并从一个优秀的学术信息学环境在OHSU。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Clinical Documentation in Electronic Health Record Systems: Analysis of Similarity in Progress Notes from Consecutive Outpatient Ophthalmology Encounters.

电子健康记录系统中的临床记录：连续门诊眼科就诊进展记录的相似性分析。

DOI：
发表时间：
2018
期刊：
AMIA ... Annual Symposium proceedings. AMIA Symposium
影响因子：
0
作者：
Huang,AbigailE;Hribar,MichelleR;Goldstein,IsaacH;Henriksen,Brad;Lin,Wei-Chun;Chiang,MichaelF
通讯作者：
Chiang,MichaelF

Response to Letter: Secondary use of electronic health record data for clinical workflow analysis.

对信的回应：电子健康记录数据的二次使用用于临床工作流程分析。