Empowering Cancer Patient-Provider Communication: A Personal Virtual Assistant for Automated Post-Discharge Engagement

项目总结/摘要 本申请是根据特别关注通知（NOSI）（编号为NOT-CA-23-041）提交的。 出院后患者和医疗服务提供者之间的沟通不足， 肿瘤患者的挑战。这些患者需要复杂的多学科护理， 随访不足和对治疗计划的误解，导致焦虑、压力和 降低依从性。这反过来又增加了再入院、癌症复发、高血压和高血压的风险。 痛苦甚至死亡 为了解决这些问题，我们的团队与丹L邓肯综合癌症中心合作 （DLDCCC），由P30赠款支持，开发基于AI的个人虚拟助理（PVA），旨在 提高医患沟通的频率、质量和及时性。PVA是一种免提， 语音激活的AI驱动系统，利用患者和医疗保健提供者的护理计划数据， 促进持续沟通。PVA包括：1）一个基于语音的，用户友好的AI信息亭 交互式平板电脑，为患者提供基本的计划细节，例如查看出院指示， 接收出院后提醒（例如，药物，护理任务），提供锻炼指导， 伸展疗法，并促进与临床工作人员的双向信息传递;以及2）全面的网络 使护理提供者能够监控依从性，修改以患者为中心的多学科护理计划， 参与共同决策，并远程更新PVA平板电脑，以防止护理重叠。网络 门户网站可以通过任何计算机、平板电脑或手机应用程序访问。 我们的初步研究已经证明了PVA在肿瘤患者中的可行性和可接受性， 临床专家在此初步数据的基础上，我们提出了一个补充拨款，以进一步评估PVA的 可行性、可扩展性和概念验证有效性，以增强患者与提供者的沟通， 坚持护理计划。 我们将对20名接受手术的肿瘤患者进行一项试点随机对照试验（RCT） 评估PVA的沟通、可接受性和可扩展性的改进的程序，以及 减少出院后不良事件的有效性。这笔补助金将有助于建立 临床验证PVA在缓解不良事件方面的可接受性和有效性的必要把握度 与医患沟通不足有关。

Project Summary/Abstract This application is submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-23-041. Inadequate communication between patients and providers following hospital discharge poses a significant challenge for oncology patients. The complex, multidisciplinary care these patients require often results in insufficient follow-up and misunderstandings of treatment plans, leading to increased anxiety, stress, and reduced compliance. This in turn elevates the risk of hospital readmission, cancer recurrence, heightened suffering, and even mortality. To address these issues, our team has collaborated with the Dan L Duncan Comprehensive Cancer Center (DLDCCC), supported by a P30 grant, to develop an AI-based Personal Virtual Assistant (PVA) designed to enhance the frequency, quality, and timeliness of patient-provider communication. The PVA is a hands-free, voice-activated AI-driven system that utilizes care plan data for both patients and healthcare providers, fostering continuous communication. The PVA comprises: 1) a voice-enabled, user-friendly AI kiosk-based interactive tablet that presents patients with essential plan details, such as reviewing discharge instructions, receiving post-discharge reminders (e.g., medication, care tasks), providing guidance for exercise and stretching therapy, and facilitating bi-directional messaging with clinical staff; and 2) a comprehensive web portal that enables care providers to monitor compliance, modify patient-centered multidisciplinary care plans, engage in shared decision-making, and remotely update the PVA tablet to prevent care overlap. The web portal can be accessed through any computer, tablet, or phone app. Our pilot study has demonstrated the feasibility and acceptability of the PVA among oncology patients and clinical experts. Building on this preliminary data, we propose a supplemental grant to further assess the PVA's feasibility, scalability, and proof-of-concept effectiveness in enhancing patient-provider communication and adherence to care plans. We will conduct a pilot randomized controlled trial (RCT) with 20 oncology patients undergoing surgical procedures to evaluate the improvement of communication, acceptability, and scalability of the PVA, as well as its effectiveness in reducing post-discharge adverse events. This supplemental grant will help establish the necessary power for clinically validating the PVA's acceptance and effectiveness in mitigating adverse events associated with inadequate patient-provider communication.