Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research

描述（由申请人提供）：外科护理和结局评估计划（SCOAP）是一个自愿的、性能监测、共享和反馈平台，来源于临床记录。SCOAP通过增加采用循证护理措施和执行"真实的世界"比较有效性研究（CER）来提高质量。在短短的四年里，SCOAP被部署到几乎所有的全州医院。SCOAP的版本用于心脏护理、普通外科护理、儿科外科护理，现在用于外周血管疾病的血管介入（VI-SCOAP）。作为CER和改进采用CER知情的临床质量改进（QI）护理措施过程的平台，SCOAP目前在规模上受到缺乏自动数据收集、数据流之间的联系以及与出院后和患者报告结果的联系的限制。从这些不同的系统中提取信息并将其链接到CER或QI的其他数据源，需要一种能够与所有可用数据系统和所有类型数据交互的信息技术解决方案。我们建议在SCOAP网络中部署Amalga UIS，通过在一个共同的框架中连接数据系统来解决系统间连接的问题。在SCOAP内部署Amalga UIS将从每个参与医院的各种电子来源、医生办公室和门诊数据流中自动检索数据。我们将自动化临床数据与管理索赔相关联，以跟踪所有后续住院，生存结果的生命状态记录，门诊就诊和药物使用数据的医疗保健支付者索赔数据集，以及护理点，纵向患者报告结果。由此产生的SCOAP CER翻译网络（CERTN）将促进有效的CER以及支持SCOAP的QI倡议周围CER驱动的护理指标过程。我们将通过使用VI-SCOAP和比较外周动脉疾病的治疗策略并解决程序安全性，证明SCOAP CERTN项目在研究中的可用性，并改进CER知情护理过程的采用。利用SCOAP网络和VI-SCOAP注册与微软的合作伙伴关系的现有优势，我们提出了几个增强，以提高我们的纵向临床和患者报告的结果数据收集的能力和可扩展性。SCOAP CERTN项目将是基于临床数据的CER的大规模真实世界资源，使用来自不同医疗保健环境的自动数据检索流。这将大大提高现有的SCOAP质量指数，提供更全面和及时的数据，并减轻参与医院的人力和资源负担。SCOAP CERTN最初的CER重点将是血管手术和干预，但该项目将成为所有临床学科研究人员评估临床结局、成本影响、PRO并将证据转化为QI的门户。重要的是，手术和介入服务跨越了医疗条件的连续性，SCOAP CERTN将立即为对AHRQ的几乎任何优先条件感兴趣的调查人员提供服务。 公共卫生相关性：SCOAP CERTN项目将是基于临床数据的CER的大规模真实世界资源，使用来自不同医疗保健环境的自动数据检索流。SCOAP CERTN项目最初的重点将是血管手术和干预，但这将是所有临床学科研究人员评估临床结局、成本影响、患者报告结局并将证据转化为临床质量改进的门户。手术和介入服务跨越医疗条件的连续性和SCOAP CERTN将有兴趣在几乎任何AHRQ的优先条件的调查人员立即的能力。

DESCRIPTION (provided by applicant): The Surgical Care and Outcomes Assessment Program (SCOAP) is a voluntary, performance surveillance, sharing and feedback platform derived from clinical records. SCOAP improves quality by increasing adoption of evidence-based process of care measures and performing "real world" comparative effectiveness research (CER). In just four years, SCOAP was deployed across nearly all statewide hospitals. Versions of SCOAP exist for cardiac care, general surgical care, pediatric surgical care, and now vascular interventions (VI- SCOAP) for peripheral vascular disease. As a platform for both CER and improved adoption of CER-informed process of care measures for clinical quality improvement (QI), SCOAP is currently limited in scale by a lack of automated data gathering, linkage between data streams and connections to post-discharge and patient reported outcomes. Drawing information out of these different systems and linking them to other data sources for CER or QI requires an information technology solution that can interact with all available data systems and all types of data. We propose to deploy Amalga UIS" across the SCOAP Network to address the problem of inter-system connectivity by linking data systems in a common, framework. Amalga UIS" deployment within SCOAP will create automated data retrieval from each participating hospitals' varied electronic sources, doctor's offices and outpatient data streams. We will link automated clinical data with to administrative claims to track for all subsequent hospitalizations, vital status records for survival outcomes, healthcare payer claims datasets for outpatient encounters and medication utilization data, and point-of-care, longitudinal patient reported outcomes. The resulting SCOAP CER Translation Network (CERTN) will facilitate efficient CER as well as support SCOAP's QI initiatives around CER-driven process of care metrics. We will demonstrate the usability of the SCOAP CERTN Project for research and improved adoption of CER-informed process of care by using VI-SCOAP and comparing the treatment strategies of peripheral arterial disease and addressing procedural safety. Leveraging existing strengths of the SCOAP network and the VI-SCOAP registry with Microsoft's partnership, we propose several enhancements to improve our capability and scalability for longitudinal clinical and patient reported outcomes data collection. The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. This will greatly enhance existing SCOAP QI by delivering more comprehensive and timely data, and in relieving manual staff and resource burden to participating hospitals. SCOAP CERTN's initial CER focus will be in vascular surgery and interventions, but the project will be a gateway for investigators from all clinical disciplines to evaluate clinical outcomes, cost-impact, PROs and to translate evidence into QI. Importantly, surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions. PUBLIC HEALTH RELEVANCE: The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. SCOAP CERTN project's initial focus will be in vascular surgery and interventions, but this will be a gateway for investigators from across all clinical disciplines to evaluate clinical outcomes, cost-impact, patient reported outcomes and to translate evidence into clinical quality improvement. Surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions.