PatientCareAnywhere: Patient Support and Empowerment Across the Care Continuum

 描述（申请人提供）：全面的生物心理社会筛查，不仅包括身体症状和心理社会问题，还包括交通、财务、工作和儿童保育等实际问题，提供了真正的机会，以最大限度地提高医疗保健和社会支持的好处，病人和他们的家人，同时提高运营效率和资源管理的医疗保健组织，因为识别和有效管理癌症护理的生物心理社会要素。早期识别患者问题对于管理痛苦、预防危机、最大限度地减少系统中断和降低医疗保健成本至关重要。由于加强沟通和更好的护理协调，还可能增加与患者、家属和卫生保健工作人员满意度有关的好处。PatientCareAnywhere作为一个以患者为中心的适应性支持性护理系统，其总体目标是改善癌症患者的治疗效果，同时降低医疗成本。PatientCareAnywhere将是一种患者赋权解决方案，通过与患者和医疗保健专业人员建立新的合作伙伴关系，促进内部恢复力和自我效能：1）地理（家庭-医院-社区-家庭）和2）医学（诊断-治疗-生存-死亡）。这种支持将根据个人的需要和健康状况进行调整，以全面的生物心理社会筛查为基础，并通过转诊、教育、社区资源参与和安全的社会沟通等多种来源进行协调。该项目是基于光明成果和希望之城（COH）之间的伙伴关系。PatientCareAnywhere将源自两个现有系统，即COH的支持屏幕和Bright Outcome的MyCaringCircle，这两个系统具有相同的愿景，并且在方法上具有互补性。Support Screen侧重于从诊所就诊开始的支持性护理，而MyCaringCircle是一个家庭/社区患者门户解决方案。这两个系统可以一起为患者提供全面的生物心理社会筛查和支持性护理，从家庭到医院，以及适应性地进行癌症护理。这是一个快速通道项目。第一阶段的目标是：1）通过焦点小组收集100名利益相关者关于预期系统功能、感知有用性和影响以及潜在采用障碍的输入; 2）通过利用支持Screen和MyCaringCircle以及改编COH的患者教育材料，设计和开发原型PatientCareAnywhere; 3）进行两次可用性测试，每次测试24名受试者，并进行一项试点研究，50名受试者。第二阶段的目标是：1）根据I期评估反馈，增强和完善I期原型，扩大疾病分期和治疗方式支持覆盖范围; 2）对516名患者进行随机对照试验，以证实我们的研究假设，即与常规护理相比，PatientCareAnywhere可实现更好的患者结局，更好的自我效能和更具成本效益的医疗服务利用。

 DESCRIPTION (provided by applicant): Comprehensive bio psychosocial screening, which covers not only physical symptoms and psychosocial issues, but also practical concerns such as transportation, finances, work and childcare, offers the true opportunity to maximize the benefits of medical care and social support to patients and their families while enhancing operational efficiency and resource management for healthcare organizations because of the identification and effective management of the bio psychosocial elements of cancer care. The early identification of patient problems is essential to manage distress, prevent crises, minimize system disruption, and reduce the costs of health care. There may be also added benefits related to patient, family and health care staff satisfaction as a result of enhanced communications and better care coordination. The overarching goal of PatientCareAnywhere as a patient-centered adaptive supportive care system is to improve patient outcomes for cancer patients while reducing healthcare costs. PatientCareAnywhere will be a patient empowerment solution to promote internal resilience and self-efficacy by creating new partnerships with patients and health care professionals across the care continuum: 1) geographically (home-hospital-community-home) and 2) medically (diagnosis-treatment-survivorship-death). Such support will be adaptive to individual's needs and health status based on comprehensive bio psychosocial screening and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication. This project is based on the partnership between Bright Outcome and City of Hope (COH). PatientCareAnywhere will be derived from two existing systems, COH's Support Screen and Bright Outcome's MyCaringCircle, which share the same vision and are complementary in their approaches. Support Screen focuses on supportive care initiated from clinic-based encounters and MyCaringCircle is a home/community-based patient portal solution. Together, these two systems can provide comprehensive bio psychosocial screening and supportive care to patients across home to hospital settings and across the continuum of cancer care adaptively. This is a Fast-Track project. Phase I aims are to: 1) Collect input from 100 stakeholders on expected system features, perceived usefulness and impacts, and potential adoption barriers via focus groups; 2) Design and develop the prototype PatientCareAnywhere by leveraging support Screen and MyCaringCircle and by adapting the patient education materials from COH; 3) Conduct two usability tests with 24 subjects each and a pilot study with 50 subjects. Phase II aims are to: 1) Enhance and refine Phase I prototype based on Phase I evaluation feedback and expand disease stage and treatment modality support coverage; and 2) Conduct a randomized controlled trial with 516 patient subjects to confirm our study hypotheses of achieving better patient outcomes, better self-efficacy, and more cost-effective health service utilization with PatientCareAnywhere as compared to usual care.