Improving Prevention Delivery Using an Interactive Information Technology System

描述（由申请人提供）：一般体检是提供预防服务最重要的医疗访问，包括癌症预防和早期发现。不幸的是，使用现有的办公系统，医生很难提供患者有资格获得的预防服务。交互式信息技术的进步为改进预防性服务的提供提供了巨大的潜力。在关于预防服务的决策研究中，我们发现医生和患者在普通体检期间评估患者是否有资格和偏好预防服务的时间与预防服务的交付时间存在竞争。本研究的目标是开发PreventIT原型，这是一个交互式的、基于信息技术的系统，将有助于通过最小化资格评估时间和最大化提供预防服务的时间来改善预防服务的提供。“PreventIT”系统将根据以下内容进行调整：1)信息组织；2)显示医生和患者的喜好。该系统将包括访问后健康行为改变计划和相关健康信息。次要目的是评估患者、医生和办公室工作人员对PreventIT原型的首选功能的看法，包括获得适当的行为改变计划和相关的健康信息。预防信息技术将由健康媒体公司利用以前制定的现有健康风险评估材料和美国预防服务工作队的预防准则开发。将与医生及其工作人员以及患者进行焦点小组讨论，以开发和完善PreventIT系统、图形图像和输出。通过对医生和患者的单独访谈，在医生和患者使用PreventIT原型时，将评估PreventIT原型的价值。在第一阶段项目之后，在第二阶段，我们建议开发完整的PreventIT功能，并预期在随机对照试验中测试PreventlT的有效性。最终，PreventIT将有助于最大限度地缩短提供推荐预防措施的时间，同时最大限度地减少医生在预防服务资格评估和制图上花费的时间。在美国，16.8%的门诊就诊（2001年为1.48亿）是为了进行一般的身体评估，医生也面临着使用办公IT系统的压力，因此拟议的产品具有巨大的市场和研究潜力。

DESCRIPTION (provided by applicant): The general physical is the most important medical visit for the delivery of preventive services including cancer prevention and early detection. Unfortunately, using current office systems, physicians have difficulty delivering the preventive services patients are eligible to receive. Advances in interactive information technology offer great potential for improving the delivery of preventive services. In the Decisions About Preventive Services study, we found that time physicians and patients spend on assessing the patient's eligibility and preferences for preventive services during the general physical visit competes with time for prevention delivery. The goal of this research is to develop the PreventIT prototype, an interactive, IT-based system that will be useful for improving delivery of preventive services by minimizing the time of eligibility assessment and maximizing the time for prevention delivery. The PreventIT system will be tailored to: 1) information organization, and 2) display preferences of physicians and patients. The system will include access to post- visit health behavior change programs and relevant health information. Secondary aims are to assess patients', physicians', and office staffs' views on the preferred features of PreventIT prototype including access to appropriate behavior change programs and relevant health information. PreventIT will be developed by HealthMedia, Inc. using existing health risk assessment materials developed previously and prevention guidelines from the United States Preventive Services Task Force. Focus groups will be conducted with physicians and their staff, and with patients to develop and refine PreventIT systems, graphical images, and output. Using individual interviews with physicians and patients, the PreventIT prototype's value will be assessed as physicians and patients use the PreventIT prototype. After this Phase I project, in Phase II, we propose to develop fully the PreventIT functionality, and anticipate testing PreventlT's effectiveness in a randomized controlled trial. Ultimately, PreventIT will help maximize the time for delivering recommended prevention, while minimizing physician time spent in preventive services eligibility assessment and charting. As 16.8% of ambulatory visits (148 million in 2001) in the US are for general physical evaluations and physicians experience pressures to employ office IT systems, the proposed product has significant market and research potential.