Improving Recognition and Management of Chronic Kidney Disease in Primary Care

项目概要/摘要 这个职业发展奖扩大了候选人目前在卫生服务领域的经验 研究包括使用电子病历提高质量。该奖项将进一步集中在 候选人在质量改进和卫生信息技术（HIT）领域的职业发展。 本申请的所有目标都旨在为候选人提供必要的培训 成为如何最有效地利用HIT来提高交付质量的专家 健康护理该奖项的四年课程的短期目标是让候选人成为一名 独立调查员，能够领导大规模的质量改进项目，并指导 初级保健实践为基础的研究网络（PBRN）。在此奖励期间，候选人计划 根据本研究项目的结果发表5-7篇论文。截至本奖励期结束时， 候选人还希望获得随后的赠款支持，以广泛实施和评估 临床决策支持（CDS）工具在慢性病管理中的实用性。培训活动 在本申请中提出的包括由成功的卫生服务研究人员进行的持续监督指导， 课程包括获得医学信息学研究生证书，并在 研讨会和国家会议。 研究提案中提议的活动的目的是确定改善 初级保健中慢性肾脏病（CKD）患者的识别和后续管理 实践在美国，重点是如何命中，更具体地说，CDS工具嵌入在一个 电子病历，可以用来实现这一目标。这些计划活动的结果如下 这可能适用于任何慢性疾病。该奖项研究计划的具体目标包括（1） 选择一组CKD质量指标用于初级保健，（2）将这些CKD指标纳入季度 在PBRN内向初级保健实践分发实践绩效报告，（3）开发CDS工具 可用于在初级保健中加强CKD患者的护理，以及（4）实施和评估 这些临床决策支持工具在其中10个实践中使用经验证的干预措施的影响。 该奖项解决了医疗保健研究和质量机构（AHRQ）的使命，以改善 为所有美国人提供医疗保健的质量、安全、效率和有效性，主要目的是 解决AHRQ的“健康信息技术”优先领域的利益，特别是解决如何HIT 可用于改善医疗保健决策。此外，由于患者教育和处方 建议是计划干预措施的组成部分，该项目还将涉及研究领域（1） HIT旨在提高药物管理的质量和安全性;（2）HIT支持以患者为中心 在乎此外，虽然响应AHRQ的HIT感兴趣的领域，这项研究计划也是一致的， 与其他AHRQ组合，包括比较有效性，预防和护理管理， 创新和新兴的想法。与AHRQ的目标一致，该研究项目旨在改善 提高所有美国人的医疗保健质量，并促进以证据为基础的决策。

Project Summary/Abstract This career development award expands upon the candidate's current experience in areas of health services research including improving quality using electronic medical records. The award will further focus the candidate's career development in the areas of quality improvement and health information technology (HIT). All of the goals of this application have been designed to provide the candidate with the training necessary to become an expert on how HIT can be most effectively utilized to improve the delivery of quality healthcare. The short term goal for the four year course of this award is for the candidate to become an independent investigator, capable of leading large scale quality improvement projects and directing a primary care practice-based research network (PBRN). During this award period, the candidate plans to publish 5-7 manuscripts based on the results of this research project. By the end of this award period, the candidate also expects to have obtained subsequent grant support to broadly implement and assess the utility of clinical decision support (CDS) tools on the management of chronic diseases. Training activities proposed in this application include continued supervised mentoring by successful health services researchers, coursework including obtaining a Graduate Certificate in Medical Informatics, and presentation of findings at both seminars and national meetings. The purpose of the activities proposed in the research proposal is to identify methods to improve the identification and subsequent management of patients with chronic kidney disease (CKD) in primary care practices across the United States, focusing on how HIT, and more specifically CDS tools embedded in an electronic medical record, can be employed to achieve this goal. The findings from these planned activities are likely to be applicable to any chronic disease. The specific aims for the research plan for this award include (1) selecting a set of CKD quality indicators for primary care, (2) incorporating these CKD indicators in quarterly practice performance reports distributed to primary care practices within a PBRN, (3) developing CDS tools that can be used to enhance care of patients with CKD in primary care, and (4) implementing and evaluating the impact of these clinical decision support tools in ten of these practices using validated interventions. This award addresses the Agency for Healthcare Research and Quality's (AHRQ) mission to improve the quality, safety, efficiency, and effectiveness of healthcare for all Americans, and is primarily intended to address the AHRQ's "Health Information Technology" priority area of interest, particularly addressing how HIT can be used to improve health care decision making. In addition, since both patient education and prescribing recommendations are a component of the planned intervention, the project will also address research areas (1) HIT to improve the quality and safety of medication management and (2) HIT to support patient-centered care. Moreover, although responsive to the AHRQ's HIT area of interest, this research plan is also consistent with other AHRQ portfolios, including comparative effectiveness, prevention and care management, and innovations and emerging ideas. Consistent with AHRQ's goals, the research project is designed to improve the quality of healthcare for all Americans and to promote evidence-based decision making.