An eHealth solution for posttraumatic stress and pain screening integrated in pediatric injury care

 描述(申请人提供)：每年有2000万美国儿童受伤，影响到孩子、他/她的家庭和社会，而社会往往承担这一代价。在8至12岁的学龄儿童中，伤害每年导致200万急诊科(ED)就诊和4万至5万人住院，导致60亿美元的医疗成本和110亿美元的失业成本。大约每6名受伤儿童中就有1人会出现持续数月并干扰康复的创伤后应激症状(PTSS)。尽管创伤后应激障碍已被证明与受伤后的健康和功能结果有关，但很少有卫生系统常规地处理受伤儿童患者的创伤后应激障碍。该项目建议解决这一关键的系统性问题，重点关注目前确定创伤后应激障碍的方法与受伤儿童、其家庭、卫生保健提供者和卫生系统的需求之间的差距。我们提出了一个综合筛查和干预系统，该系统利用电子健康的进步和适合发展的参与战略，以及不断变化的经济格局，为卫生系统提供激励，以优化短期和长期患者结果，并有意义地使用卫生信息技术。我们将开发一个原型系统，并评估其在关键用户中的可用性、可行性和实用性 组。同时，我们将评估实施的技术可行性，并在向主要利益攸关方广泛学习的基础上制定初步商业化计划。

 DESCRIPTION (provided by applicant): Each year, 20 million US children are injured, affecting the child, his/her family, and society, which often bears the cost. Among school-age children age 8 to 12, injuries lead to 2 million emergency department (ED) visits and 40,000-50,000 hospital admissions annually, resulting in $6 billion in medical costs and $11 billion more in work loss costs. Approximately 1 in 6 injured children will develop posttraumatic stress symptoms (PTSS) that persist for months and interfere with recovery. Although PTSS has been shown to be associated with health and functional outcomes following injury, few health systems routinely address PTSS in injured pediatric patients. This project proposes to address this critical, systemic problem by focusing on the gap between current approaches for identifying PTSS and the needs of injured children, their families, health care providers, and health systems. We propose an integrated screening and intervention system that takes advantage of advances in e-Health and developmentally-appropriate engagement strategies, as well as a shifting economic landscape that provides health systems with incentives for optimizing short- and long-term patient outcomes and for meaningful use of health information technology. We will develop a prototype system and evaluate its usability, feasibility, and utility among key user groups. Simultaneously, we will evaluate the technical feasibility of implementation and delineate an initial commercialization plan grounded in extensive learning from key stakeholders.