Facilitating Treat-to-Target Using Novel Health Technology with Decision support

在这个项目中，我们将扩展并严格评估NIH，ACR和 AHRQ在新型健康信息技术方面由项目组开发：使系统化 在常规临床中收集和集成患者报告结果(PRO)和医疗保健提供者数据 实践；利用这些数据促进患者和提供者围绕类风湿的最佳使用进行互动 关节炎(RA)疗法；将这些数据与电子健康记录(EHR)系统中的信息相结合；以及 证明对类风湿关节炎患者的过程和结果都有好处。我们的具体目标是： 目标1：改进和整合电子收集和使用来自RA的PRO数据的新方法 帮助患者更好地进行患者与提供者之间的沟通，并实现目标治疗(T2T)目标。 我们将进一步中试我们研究团队开发的新颖和最近完成的技术：1) 类风湿性关节炎疾病活动(Ready)电子测量工具，将从以下位置收集数据 患者在医生办公室和患者家中使用多种现有的经验证的PRO仪器，通过 互联网和SMARI：手机(如iPhone)；2)专注于最佳利用生物的风险沟通工具 考虑改变治疗的类风湿性关节炎患者的代理；以及3)通过 ACR新的国家注册机构--风湿病信息有效性系统(RISE)。具有关键的 来自包括患者在内的许多关键利益相关者的意见，我们将在各种临床应用中改进这一集成工具 使用常用计算设备(例如iPad)创建高度可推广的资源的实践 它可以在全国范围内的社区和学术实践环境中部署。 目的2：进行一项整群随机研究，以检查综合电子工具对 优化类风湿关节炎患者护理。我们将检验这样一种假设，即类风湿关节炎患者在医生那里接受治疗 随机接受干预工具的做法将获得更好的RA结果，由 在每名医生的执业中，达到低疾病活跃度或 随机分组一年后缓解。

In this project, we will extend and rigorously evaluate past investments made by the NIH, ACR, and AHRQ in novel health information technology developed by the project team to: enable the systematic collection and integration of Patient Reported Outcome (PRO) and healthcare provider data in routine clinical practice; make use of this data to facilitate patient-provider interaction around optimal use of rheumatoid arthritis (RA) therapies; integrate this data with information in Electronic Health Record (EHR) systems; and demonstrate benefit for both process and outcomes among patients with RA. Our specific aims are: Aim 1: To refine and integrate a novel approach to the electronic collection and use of PRO data from RA patients to facilitate better patient-provider communication, and achievement of Treat to Target (T2T) goals. We will further pilot-test novel and recently-completed technologies developed by our research team: 1) the RhEumatoid Arthritis Disease activitY (READY) electronic measurement tool that will collect data from patients using multiple existing, validated PRO instruments at physician offices and patients' homes via the Internet and smari:phones (e.g. iPhone); 2) a risk communication tool focused on optimal use of biologic agents for RA patients considering changes in therapy; and 3) linked EHR-based data available through the ACR's new national registry, the Rheumatology Informatics System for Effectiveness (RISE). With critical input from many key stakeholders, including patients, we will refine this integrated tool in a variety of clinical practices using commonly available computing devices (e.g. iPad) to create a highly generalizable resource that can be deployed across both community and academic practice settings nationally. Aim 2: To conduct a cluster-randomized study to examine the effect of the integrated electronic tool to optimize RA patient care. We will test the hypothesis that RA patients receiving care in the physician practices randomized to receive the intervention tool will attain better RA outcomes as quantified by the proportion of patients in each physicians' practice that have achieved a T2T goal of low disease activity or remission one year after randomization.