Interactive HIT to Promote Ambulatory Safety among Vulnerable Diabetes Patients

描述（由申请人提供）：这是一份针对Urmimala Sarkar博士的K08奖申请，她是加州大学旧金山分校的一名普通内科医生，她是一名年轻的研究人员，致力于弱势慢性病患者的门诊患者安全。本次K08奖将为她实现以下目标提供支持：(1)成为以患者为导向的临床研究专家，为弱势糖尿病患者提供门诊安全性；(2)调查交互式卫生信息技术对患者安全监测和促进的效用；(3)在临床研究中应用先进的生物统计学方法；(4)应用新方法，如根本原因分析和德尔菲法；(5)发展独立的临床研究事业。她组建了一个指导团队，其中包括主要导师Dean Schillinger博士（从事卫生传播和慢性病管理方面的研究）和3名共同导师：患者安全领域的国际专家Robert Wachter博士；埃里克·维廷霍夫博士，研究设计和生物统计分析专家；以及在促进患者安全方面具有专长的研究员玛丽·布莱根（Mary Blegen）博士。她的团队还包括4名科学顾问：全国知名的门诊安全监测研究专家Wilson Pace博士；Kaveh Shojania博士是质量改进项目评估和患者安全研究方面的专家；联合委员会的患者安全专家南希·库普卡（Nancy Kupka）博士；以及哈工大专家迈克尔·布鲁姆博士。对门诊患者，特别是慢性病易感人群中不良事件的程度、性质或演变知之甚少。在目标1中，Sarkar博士将利用现有的交互式健康信息技术（HIT）自我管理程序来监测500名糖尿病患者的安全性。她将采用先进的统计方法来识别风险最高的患者，并对检测到的事件进行根本原因分析。在目标2中，她将研究几种监测机制的相对产量。在目标3中，她将使用德尔菲法来评估所发现的不良事件的相关性和严重程度以及预防/改善的可行性。公共卫生相关性：提高我们对弱势糖尿病患者患者安全问题的性质和病因的理解是至关重要的，可以指导未来在这一高危人群中的安全性评估和推广。

DESCRIPTION (provided by the applicant): This is an application for a K08 award for Dr. Urmimala Sarkar, a general internist at the University of California, San Francisco, who is establishing herself as a young investigator in ambulatory patient safety among vulnerable chronic disease patients. This K08 award will provide her with the support to accomplish the following goals: (1) to become expert at patient-oriented clinical research in ambulatory safety for vulnerable diabetes patients; (2) to investigate the utility of interactive health information technology for patient safety surveillance and promotion; (3) to implement advanced biostatistical methods in clinical studies; and (4) to apply novel methods such as root cause analysis and the Delphi method; and (5) to develop an independent clinical research career. She has assembled a mentoring team comprised of a primary mentor, Dr. Dean Schillinger, who conducts research in health communication and chronic disease management, and 3 co-mentors: Dr. Robert Wachter, an international expert in the field of patient safety; Dr. Eric Vittinghoff, and expert in study design and biostatistical analysis; and Dr. Mary Blegen, a researcher with expertise in patient safety promotion. Her team also includes 4 scientific advisors: Dr. Wilson Pace, a nationally renowned expert in ambulatory safety surveillance research; Dr. Kaveh Shojania, an expert in evaluation of quality improvement programs and in patient safety research; Dr. Nancy Kupka, an expert in patient safety at the Joint Commission; and Dr. Michael Blum, an expert in HIT. Little is known about the extent, nature, or evolution of adverse events among ambulatory patients, especially among vulnerable groups with chronic diseases. In Aim 1, Dr. Sarkar will leverage an existing, interactive health information technology (HIT) self-management program to monitor safety among 500 diabetes patients. She will employ advance statistical methods to identify patients at highest risk and perform root cause analysis for detected events. In Aim 2, she will investigate the comparative yield for several surveillance mechanisms. In Aim 3, she will use the Delphi method to evaluate the relevance and severity of adverse events that were identified and the feasibility for prevention/amelioration. Public health relevance: Improving our understanding of the nature and etiology of patient safety problems in disadvantaged diabetes patients is critical and can guide future safety assessment and promotion in this high-risk population.