Technology-enabled Type 1 Diabetes Education and Support (T1DES)System

描述（由申请人提供）：1型糖尿病的管理需要患者的警惕监测，患者经常遇到许多可能妨碍适当管理的障碍。障碍可能包括教育、心理和支持问题。Polaris Health Directions是一家小型企业，与宾夕法尼亚大学护理学院合作开发了技术支持的1型糖尿病教育和支持（T1 DES）系统，该系统将通过提供以下服务来帮助和支持糖尿病管理：（1）基于网络的自动化管理评估（技能，知识，障碍，并发症的常规筛查），可以在任何互联网连接的个人或平板电脑上完成;（2）具有定制的教育材料和支持的真实的时间患者报告;（3）强调心理社会问题、管理障碍和常规筛查需求的真实的时间1页临床医生报告;（4）电子学习工具（基于网络的学习模块和网络研讨会）;（5）增强的消息传递系统（EMS;即，自动化文本消息和电子邮件），以发送患者提醒，并支持办公室访问之间的糖尿病管理，以及（6）通过HL 7接口集成到电子健康记录（EHR）中，并自动转介给心理健康提供者，社会工作者和糖尿病专家的能力。在第一阶段， 将进行一项研究，以证明T1 DES通过电子评估、电子学习和电子信息支持糖尿病管理的可行性和潜力。具体目标1：根据最终用户访谈（患者，家庭成员，糖尿病提供者）开发T1 DES原型;完成教育模块和电子消息内容;设计评估和报告;编写和测试T1 DES软件;培训临床医生使用该系统，并在费城儿童医院的儿童糖尿病中心进行现场测试（1-6个月）。具体目标二：进行初步研究，并评估最终用户对系统的接受程度（6-12个月）。初步研究将招募40名患者（13-18岁）和40名参与患者糖尿病管理的家庭成员。患者将完成评估，在下一次预约之前设定目标，并收到一份量身定制的教育反馈报告，该报告将由糖尿病提供者进行审查。然后，患者将根据他们选择的糖尿病管理目标每天收到电子邮件，持续3个月。此外，家属和患者将收到预约提醒，并可以访问在线电子学习工具（教育模块和网络研讨会）。在参加研究三个月后，参与者将被要求完成一项关于T1 DES系统的教育和支持优势、可读性和易用性的满意度调查，这将有助于为进一步的产品开发提供信息。在II期，将进行一项多中心随机对照试验，以检查T1 DES对HbA 1C、管理技能、知识和障碍、医疗结局和医疗保健利用的影响。第二阶段的其他目标将包括：与EHR整合;为临床医生开发基于网络的多媒体培训;以及交互式提供者-患者文本和语音消息。

DESCRIPTION (provided by applicant): Management of Type 1 diabetes requires vigilant monitoring by patients who often encounter numerous barriers that can impede proper management. Barriers can include educational, psychosocial, and support issues. Polaris Health Directions, a small business, and University of Pennsylvania School of Nursing have partnered to develop the Technology-enabled Type 1 Diabetes Education and Support (T1DES) system that will assist and support diabetes management by providing: (1) an automated, web-based management assessment (skills, knowledge, barriers, routine screenings for complications) that can be completed on any internet-connected personal or tablet computer; (2) real time patient report with tailored educational materials and support; (3) real time 1-page clinician report that highlights psychosocial issues, barriers to management, and need for routine screening; (4) e-learning tools (web-based learning modules and webinars); (5) enhanced messaging systems (EMS; i.e., automated text messaging and emails) to send patient reminders and to support diabetes management between office visits, and (6) the capability to be integrated into electronic health records (EHR) via HL7 interface and automate referrals to mental health providers, social workers, and diabetes specialists. In Phase I, a pilot study will be conducted to demonstrate the feasibility and potential of T1DES to support diabetes management through e-assessment, e-learning and e-messaging. Specific Aim 1: Develop the T1DES prototype based on end-user interviews (patient, family members, diabetes providers); finalize educational modules and e-messaging content; design assessment and reports; write and test T1DES software; train clinicians to use the system, and conduct a Field Test at the Diabetes Center for Children at Children's Hospital of Philadelphia (Months 1-6). Specific Aim 2: Conduct a Pilot Study and evaluate the acceptance of the system by end-users (Months 6-12).The Pilot Study will enroll 40 patients (13-18 years old) and 40 family members involved in the patient's diabetes management. Patients will complete the assessment, set goals to achieve before their next appointment, and receive a tailored, educational feedback report that will be reviewed with a diabetes provider. The patient will then receive e-messages daily for 3-months based on the diabetes management goals they have selected. Additionally, family members and patients will receive appointment reminders and have access to online e-learning tools (educational modules and webinars).Three months after enrolling in the study, participants will be asked to complete a satisfaction survey regarding the educational and supportive benefits of the T1DES system, readability, and ease of use that will help inform further product development. In Phase II, a multi-site randomized controlled trial will be conducted to examine T1DES impact on HbA1C, management skills, knowledge, and barriers, medical outcomes, and healthcare utilization over a one year period. Other Phase II goals will include: integration with EHR; development of a web-based multimedia training for clinicians; and interactive provider-patient text and voice messaging.