Randomized controlled trial embedded in an electronic health record

嵌入电子健康记录的随机对照试验

• 批准号: 7680092
• 负责人: JAMES S KAHN
• 金额: $ 39.3万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7680092
• 关键词: Randomized; controlled; trial; embedded; electronic

DESCRIPTION (Provided by Applicant): HIV/AIDS is a non-curable chronic illness. Applying the chronic care model (CCM) to this disease may lead to improved outpatient care and easier, safer clinical transitions for HIV infected patients. Clinical information systems (CIS) are a key element in the CCM. While CIS have focused on the provider as the recipient of critical data, clinical information systems that target patients as consumers might also contribute to improved health care. The electronic personal health record (PHR) is a recent, but increasingly common, patient-oriented information system allowing patients to view data necessary to guide practical outpatient decisions and to provide portability of clinical data between healthcare venues. Our hypothesis is that a secure enhanced PHR (ePHR) that combines meaningful information, web-based tools for support, and reminders will also provide a substantial opportunity to promote self-management and will lead to improved health outcomes. In this proposal we will work directly with HIV/AIDS patients in a public health setting to model processes that contribute to improved health outcomes in the realms of patient behaviors, patient-clinician trust, clinical outcomes, medication safety and utilization. Accordingly, the specific aims are: 1. (Build Infrastructure and Content) Extend and secure a web-based ePHR for HIV/AIDS patients receiving care in a public health setting, providing these users with tools to access and understand their medical records including resources for decision support, information retrieval and communication; 2. (Evaluation of ePHR) Evaluate patient and clinician experience with ePHR including patient access and use patterns, use of support tools for tobacco cessation, depression abatement, anxiety reduction, adherence improvement, and patient and clinician satisfaction; 3. (Outcome Assessment) Determine the effect of PHR use in five domains: (a) Clinical outcomes (CD4+T cells, detectable HIV RNA, depression, anxiety, quality of life); (b) Patient behaviors (adherence, tobacco use); (c) Interaction (trust, health promotion); (d) Safety (documentation of drug allergies, medication reconciliation); and (e) Utilization of resources (office visits, emergency visits and hospitalizations).

描述（申请人提供）：艾滋病是一种无法治愈的慢性疾病。将慢性护理模式（CCM）应用于这种疾病可能会改善门诊护理，并使艾滋病毒感染患者更容易、更安全地进行临床过渡。临床信息系统（CIS）是CCM的关键要素。虽然CIS侧重于提供者作为关键数据的接受者，但将患者作为消费者的临床信息系统也可能有助于改善卫生保健。电子个人健康记录（PHR）是最近出现的一种面向患者的信息系统，但越来越普遍，它允许患者查看必要的数据，以指导实际的门诊决策，并提供医疗保健场所之间临床数据的可移植性。我们的假设是，将有意义的信息、基于网络的支持工具和提醒相结合的安全增强型PHR （ePHR）也将为促进自我管理提供大量机会，并将导致改善的健康结果。在这项建议中，我们将在公共卫生环境中直接与艾滋病毒/艾滋病患者合作，对有助于在患者行为、患者-临床医生信任、临床结果、药物安全和利用等领域改善健康结果的过程进行建模。因此，具体目标是：