Improving Care for Acute Respiratory Infection

描述（由申请人提供）：候选人，学术一般内科医生，正在申请指导临床科学家发展奖（K08），以发展和提高成为成功的独立卫生服务研究人员所需的技能。他的长期目标是开发一个多学科研究计划，致力于改善急性呼吸道感染（阿里斯）患者的护理，同时改善私人和公共卫生系统之间的联系，为自然发生的疾病集群和生物恐怖主义提供监测。 他职业发展的核心是他所组建的强大的机构承诺和指导团队。多学科的教育计划是建立在获取信息学，先进的生物统计学，病人安全，研究伦理，公共卫生和疾病监测的新技能。除了正式的课程外，该计划还包括地方研讨会，国家科学会议和同行评审的结果出版物。 研究计划的四个具体目标中的每一个都涉及开发和实施基于电子病历的ARI访视模板，即ARI智能集。具体目标1是开发ARI Smart Set，它将标准化护理文件，并使提供者能够轻松访问临床信息、在线决策支持和患者教育材料。具体目标2是对ARI Smart Set进行随机对照试验，以评估其在减少初级保健实践中抗生素处方方面的有效性。具体目标3a是将ARI智能装置与国家疾病监测计划（国家生物恐怖主义综合征监测示范项目）连接起来，在个人和公共卫生系统之间提供自动化的双向联系。具体目标3b是进行一项随机对照试验，通过ARI Smart Set为临床医生提供有关流感和其他呼吸道疾病在单个患者附近流行的即时数据。主要结果是流感样疾病患者30天抗生素处方。该研究计划将提供有关阿里斯患者护理以及个人和公共卫生系统之间接口的关键信息。研究计划还将为候选人提供医学信息学，疾病监测，随机对照试验设计和实施，数据收集，数据分析，数据库管理，统计分析和干预研究方面的重要经验。

DESCRIPTION (provided by the applicant): The candidate, an academic general internist, is applying for a Mentored Clinical Scientist Development Award (K08) to develop and enhance the skills necessary to become a successful independent health services researcher. His long-term goal is to develop a multidisciplinary research program dedicated to improving the care of patients with acute respiratory infections (ARIs) while improving links between the private and public health systems to provide surveillance for naturally occurring disease clusters and bioterrorism. Central to his career development is the strong institutional commitments and mentoring team that he has assembled. The multidisciplinary educational plan is built upon acquiring new skills in informatics, advanced biostatistics, patient safety, research ethics, public health, and disease surveillance. In addition to formal coursework, the plan includes local seminars, national scientific meetings, and peer-reviewed publication of results. Each of the four specific aims of the research plan involves the development and implementation of an electronic medical record-based template for ARI visits, the ARI Smart Set. Specific Aim 1 is to develop the ARI Smart Set, which will standardize documentation of care and give providers easy access to clinical information, on-line decision support, and patient education materials. Specific Aim 2 is to perform a randomized controlled trial of the ARI Smart Set to assess its effectiveness in decreasing antibiotic prescribing in primary care practices. Specific Aim 3a is to connect the ARI Smart Set with a national disease surveillance program, the National Bioterrorism Syndromic Surveillance Demonstration Project, to provide an automated, bi-directional link between the personal and public health systems. Specific Aim 3b is to perform a randomized controlled trial of providing clinicians with point-of-care, real-time data about the prevalence of influenza and other respiratory illnesses in an individual patient's neighborhood through the ARI Smart Set. The primary outcome is 30-day antibiotic prescribing for patients with influenza-like illnesses. The research plan will provide critical information about the care of patients with ARIs and the interface between the personal and public health systems. The research plan will also provide crucial experience for the candidate in medical informatics, disease surveillance, randomized controlled trial design and implementation, data collection, data analysis, database management, statistical analysis, and intervention research.