Integrated Tracking, Referral, and Algorithmic Management (I-TREC) System for Hypertension and Diabetes

高血压和糖尿病综合跟踪、转诊和算法管理 (I-TREC) 系统

• 批准号: 9555026
• 负责人: Nikhil Tandon
• 金额: $ 27.54万
• 依托单位: ALL-INDIA INSTITUTE OF MEDICAL SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9555026
• 关键词: Address; Adherence; Adoption; Adult; Advisory Committees; Algorithms; Applied Research; Appointment; Caring; Catchment Area; Cessation of life; Chronic Disease; Collaborations; Communities; Community Surveys; Comorbidity; Comprehensive Health Care; Cost efficiency; Data; Databases; Decision Support Systems; Diabetes Mellitus; Disease Management; Early Diagnosis; Effectiveness; Ensure; Equipment and supply inventories; Experimental Designs; Focus Groups; Foundations; Goals; Government; Guidelines; Health; Health Professional; Health care facility; Healthcare; Healthcare Systems; Hypertension; India; Individual; Information Technology; Institutes; Institution; International; Intervention; Interview; Life Style; Longevity; Maintenance; Measures; Medical; Methods; Mission; Modeling; Monitor; Outcome; Paper; Patient Appointment; Patients; Performance; Pharmaceutical Preparations; Population; Process; Program Sustainability; Provider; Public Health; Recommendation; Recording of previous events; Registries; Resources; Retrieval; Risk Factors; Rural; Science; Service delivery model; System; Testing; Text Messaging; Time; Training; Treatment outcome; Universities; Work; base; blood pressure regulation; care coordination; care delivery; care systems; cost; design; diabetes management; electronic data; evidence base; follow-up; health administration; health care delivery; hypertension control; hypertension treatment; implementation science; improved; individual patient; prehypertension; premature; programs; screening; tool

PROJECT ABSTRACT Nearly one in three Indian adults has hypertension and many more have pre-hypertension. In rural India, roughly three-quarters of adults with hypertension never receive treatment, and 90% of individuals receiving treatment for hypertension fail to achieve adequate blood pressure control. The current Indian public healthcare system is neither oriented nor equipped to process the total caseload of hypertension. This is due in part to poor coordination across facilities at different levels of the healthcare system and lack of mechanisms to efficiently follow-up with or refer patients, resulting in a mismatch between patient needs and treatment availability as well as inefficient use of limited healthcare resources. To address these gaps in the healthcare delivery model, the All India Institute of Medical Sciences, Public Health Foundation of India, and Emory University will partner to develop an Integrated Tracking, Referral, Electronic Decision Support and Care Coordination (I-TREC) package focused on hypertension and its most frequent comorbidity, diabetes. This multi-component package will improve coordination of care across various levels of the healthcare facility hierarchy and will include electronic data capture, electronic decision support, and care coordination training for healthcare professionals; text messaging to patients for appointments and disease management advice; facility level retrieval of patient history and inventory needs; and health administration monitoring of data across levels. Our objectives are to (1) adapt I-TREC for implementation within the public healthcare system with input of local, national, and international stakeholders; (2) implement I-TREC across all 15 health facilities comprising the government healthcare system in Banga Block (sub-district level administrative unit) of Punjab state, India; and (3) evaluate I-TREC using a quasi-experimental design by comparing performance of key indicators in Banga Block with another non-neighboring but comparable block in the same district. The proposed T4 intervention promises to consolidate previously proven strategies at single-levels of the healthcare hierarchy into a coordinated system of care delivery that relies entirely on the existing healthcare workforce. Findings will have the potential to revolutionize care for deadly chronic diseases across India in the most vulnerable and hard-to-reach patients who rely heavily on the government healthcare system and generate a scalable model that can be applied to other similar settings.

项目摘要