Building an interface integrating PCP's and an online diabetes prevention program

描述(由申请人提供)：具有里程碑意义的糖尿病预防计划证明，全面的生活方式改变可以在短期和长期内明确地预防糖尿病。最近，DPP的互联网改编已经成功实施，以帮助向更广泛的患者群体传播DPP的核心要素。到目前为止，这个名为Goals的DPP的网络版本一直是初级保健提供者自主发挥作用的。Goals的参与者指出，该计划与他们的初级保健提供者的整合是参与该计划并取得成功的关键动机。目标和初级保健团队之间缺乏沟通，限制了初级保健和基于互联网的干预措施在糖尿病预防工作中的潜在协同作用。该项目的目标是开发一个新的接口之间的目标和一个广泛使用的商业电子病历平台。该建议以研究小组的经验和专长为基础，建议的具体目标是：(1)确定初级保健提供者更喜欢从参加网络糖尿病预防计划的患者那里获得的生活方式变化数据的类型、数量、频率和地点；(2)在Goals、基于循证的互联网DPP的生活方式干预和初级保健电子病历(EMR)工作流之间开发一个接口；以及(3)测试网络糖尿病预防计划和初级保健EMR之间接口的可用性、工作流集成和技术可行性。为了实现这些目标，我们提出了一项为期两年的研究，在这项研究中，我们将1)使用该系统采访和观察提供者、患者和在线教练，并得出在Goals和EMR之间沟通的偏好；2)开发一个原型界面，通过EMR界面与提供者共享患者进展数据；以及3)可用性测试和优化原型的工作流集成，以创建一个功能齐全的界面。这项研究利用了一些创新的方法，例如“近况”可用性测试，专注于实时工作流程集成，以及嵌入当今美国最广泛使用的商业EHR系统中(提供了巨大的传播潜力)。它还利用了可用性测试、初级保健决策支持工具开发、卫生服务研究以及与DPP调查人员和GOALS系统开发商的合作方面的独特专业知识。这些创新使拟议的接口开发研究具有实现其目标的独特地位，并提供了患者和提供者之间令人兴奋的新沟通模式，并有助于鼓励更多成功的糖尿病预防行为。

DESCRIPTION (provided by applicant): The landmark Diabetes Prevention Program demonstrated that comprehensive lifestyle change can definitively prevent diabetes over the short and long-term. Recently, internet based adaptations of the DPP have been successfully implemented to help disseminate the core elements of the DPP to a wider patient population. To date, this web version of the DPP called GOALS has functioned autonomously of the primary care provider. Participants of GOALS cited integration of the program with their primary care provider as a key motivator to involvement and success with the program. The lack of communication between GOALS and the primary care team limits the potential synergies in diabetes prevention efforts between primary care and internet based interventions. The objective of this project is to develop a novel interface between GOALS and a widely used commercial electronic medical record platform. Building on the experience and expertise of the study team, the specific aims of the proposal are: (1) To determine the type, amount, frequency and location of lifestyle change data that primary care providers prefer from patients enrolled in a web-based diabetes prevention program; (2) To develop an interface between GOALS, an evidence-based internet DPP based lifestyle intervention, and the primary care electronic medical record (EMR) workflow; and (3) To test the usability, workflow integration and technical feasibility of an interface between a web-based diabetes prevention program and the primary care EMR. To achieve these aims, we propose a two year study in which we will 1) Interview and observe providers, patients and online coaches using the system and eliciting preferences for communication between GOALS and the EMR; 2) Develop a prototype interface that shares data on patient progress with GOALS with the provider through a EMR interface; and 3) Usability test and optimize workflow integration of the prototype to create a fully functional interface. The study leverages innovative approaches such as "near-live" usability testing, a focus on real-time workflow integration, and embedding in the most widely used commercial EHR system in the US today (providing enormous dissemination potential). It also draws on unique expertise in usability testing, primary care decision support tool development, health services research and collaboration with DPP investigators and the developers of the GOALS system. These innovations make the proposed interface development study uniquely positioned to achieve its aims and provide an exciting new mode of communication between patients and providers and help encourage more successful diabetes prevention behaviors.