Safe and Equitable Telehealth for Chronic Conditions (SafE-T C2) Learning Laboratory

摘要 拟议研究的目标是开发一个患者安全学习实验室，该实验室将识别 与远程医疗(同步视频和电话访问)相关的突出患者安全问题，重点 针对慢性病患者，设计、开发、实施和评估新的安全解决方案。这个 针对慢性病的安全和公平的远程医疗(SAFE-T C2)学习实验室地址众多 医疗研究和质量优先机构，并将专注于提高安全、质量和价值 医疗保健。该实验室将解决慢性病、健康公平和弱势群体问题，以及 初级保健。学习实验室的基础是一个社会技术系统工程框架。 它考虑了可能导致患者安全问题的多种因素，包括技术、人员、 流程和策略。目标1是问题分析阶段，将使用多管齐下的方法来 确定与远程医疗相关的患者安全问题。目标2是解决方案设计和开发阶段。在这 包括行业合作伙伴在内的不同利益攸关方将共同设计和开发安全解决方案。 目标3是执行和评估阶段。开发的解决方案将在不同的 跨多个医疗系统的门诊诊所以及流程措施和结果措施将 用于确定解决方案在解决预期的患者安全问题方面的有效性。 这项研究是MedStar Health、Stanford Health Care和 山间医疗保健公司。该项目利用了不同研究团队的广泛专业知识， 包括系统工程师和人为因素专家、健康公平研究人员、临床医生和运营人员 领导者、数据科学家和临床应用程序开发人员以及实施科学家。实验室 还包括行业合作伙伴、健康公平咨询团队、健康公平社区咨询委员会以及 一个病人和家庭咨询委员会，将向项目的所有方面提供信息。 这项研究的贡献将包括确定突出的安全问题、开发和 实施可跨不同医疗机构扩展的安全解决方案，以及新知识 其中安全解决方案对提高远程医疗安全最为有效。我们严谨的传播计划 包括将结果传达给政策制定者和倡导团体、临床领导和其他 服务于改善临床实践的组织，以及学术受众。结果将会公布 在项目开始后的4-6个月内，我们将在建议的整个过程中传播我们的研究结果 为期四年的项目。

ABSTRACT The objective of the proposed research is to develop a patient safety learning laboratory that will identify prominent patient safety issues associated with telehealth (synchronous video and phone visits), with a focus on patients with chronic conditions, and design, develop, implement, and evaluate novel safety solutions. The Safe and Equitable Telehealth for Chronic Conditions (SafE-T C2) learning laboratory addresses numerous Agency for Healthcare Research and Quality priorities and will focus on improving safety, quality, and value of healthcare. The laboratory will address chronic conditions, health equity and vulnerable populations, and primary care. At the foundation of the learning laboratory is a socio-technical system engineering framework that considers multiple factors that may contribute to patient safety issues including technology, people, processes, and policies. Aim 1 is the problem analysis phase and a multipronged approach will be used to identify telehealth related patient safety issues. Aim 2 is the solution design and development phase. In this phase a diverse set of stakeholders, including industry partners, will co-design and develop safety solutions. Aim 3 is the implementation and evaluation phase. Developed solutions will be implemented in different outpatient clinics across multiple healthcare systems and process measures and outcome measures will be used to determine effectiveness of the solutions in addressing the intended patient safety issues. The research effort is a unique collaboration between MedStar Health, Stanford Health Care, and Intermountain Healthcare. This project utilizes the extensive expertise of the diverse research team which includes system engineers and human factors experts, health equity researchers, clinicians and operational leaders, data scientists and clinical application developers, as well as implementation scientists. The laboratory also includes industry partners, a health equity advisory team, a health equity community advisory board, and a patient and family advisory board that will inform all aspects of the project. Contributions from this research will include identification of prominent safety issues, development and implementation of safety solutions that can be scaled across different healthcare facilities, and new knowledge of which safety solutions are most effective to improving telehealth safety. Our rigorous dissemination plan includes communication of results to policymakers and advocacy groups, clinical leaders and other organizations that serve to improve clinical practice, as well as academic audiences. Results will be available within 4-6 months of project start and we will disseminate our findings throughout the course of the proposed four-year project.