Is there a digital divide in Chronic Kidney Disease (CKD)?

描述（由申请人提供）：健康信息技术（IT）为改善慢性疾病的治疗结果提供了新的工具，但很少有IT应用程序是专门为慢性肾脏疾病（CKD）人群设计的，其中包括许多受“数字鸿沟”不利影响的患者，并面临用药错误的风险。申请类型：K23指导患者导向研究职业发展奖。职业发展目标：通过独特的教学课程和执行新颖的前瞻性研究计划，培养评估、开发和实施健康IT解决方案的技能，以提高CKD护理的安全性。研究目的：1)检查被调查的感知电子素养与CKD患者用药错误之间的关系，2)评估功能计算机素养与CKD患者用药错误之间的关系，使用一个简单的基于网站的任务列表的绩效评估，以及3)试点一个新的IT原型药物查询系统（MIS），该系统提供CKD中常见药物安全使用的预防信息。核心研究和人群：慢性肾功能不全队列（CRIC）研究，这是一项全国性的CKD成人队列研究。研究方法：目标1：在年度访问中调查来自4个CRIC站点的CRIC参与者（n=1150），了解他们的手机使用情况，并使用经过验证的电子健康素养量表（eHEALS）感知电子健康素养。目标2：评估三个CRIC中心参与者（n=195）访问“eCRIC”网站和结构化作业列表的人机交互，旨在衡量参与者的计算机熟练程度。评估目标1和2措施与新药物错误分类方案定义的累积安全威胁程度之间的关系。目标3：评估当地CRIC参与者（n = 50）对嵌入基于个人数字助理（例如iPod Touch）的新型MIS应用程序的有效使用情况，该应用程序在输入实际药物时通知用户特定药物的安全性，并发出警告或不安全警报。报告结果的正确性将由研究人员进行验证。职业发展规划：多学科指导团队和课程已经组建，以培养Diamantidis博士在医疗保健信息学，患者参与方法和移动技术应用方面的工作知识。指导团队将监督Diamantidis博士的专业发展和对健康信息技术及其在慢性病人群中的应用的工作理解。这些获得的能力将增强她目前在临床流行病学方面的背景。预期结果：这个以患者为导向的指导研究职业发展奖将帮助Diamantidis博士实现她的近期和长期目标，支持：1)新的和独特的健康信息技术研究培训，2)与专家信息学研究人员的多学科合作，3)流行病学的高级培训，4)生成关键的初步数据，以促进她在CKD中实现疾病定制健康信息技术应用的专业领域过渡到独立研究。

DESCRIPTION (provided by applicant): Health information technology (IT) offers new tools to improve outcomes in chronic diseases, yet few IT applications have been designed specifically for the chronic kidney disease (CKD) population, which includes many patients adversely affected by the "Digital Divide" and at risk for medication errors. Application type: K23 Mentored Patient-Oriented Research Career Development Award. Career development aim: Develop skills in the evaluation, development, and implementation of health IT solutions to improve the safety of care in CKD through a unique didactic curriculum and execution of a novel prospective study plan. Study aims: 1) examine the association between surveyed perceived e-literacy and medication errors in individuals with CKD, 2) assess the relationship between functional computer literacy and medication errors in individuals with CKD using performance assessment of a simple website-based task list, and 3) pilot a novel IT prototype medication inquiry system (MIS) which provides precautionary information on the safe usage medications common in CKD. Core study and population: Chronic Renal Insufficiency Cohort (CRIC) study, which is a nationally cohort of adult participants with CKD. Research methods: Aim 1: Survey CRIC participants from 4 CRIC sites (n=1150) at an annual visit regarding their mobile phone usage, and perceived e-health literacy with the validated eHealth Literacy Scale (eHEALS). Aim 2: Assess the human-computer interactions of participants at three CRIC centers (n=195) accessing an "eCRIC' website and a structured assignment list, designed to measure participants' computer proficiency. Evaluate the association between Aims 1 & 2 measures and degree of cumulative threat to safety defined by a novel medication error classification scheme. Aim 3: evaluate local CRIC participants (n = 50) effective use of a novel MIS application embedded on a personal digital assistant-based (e.g. iPod Touch"), which notifies users about the safety of specific medications upon input of their actual medications with CAUTION or NOT SAFE alerts. Correctness of reported results will be verified by study staff. Career development plan: Multidisciplinary mentorship team and curriculum has been assembled to foster Dr. Diamantidis' working knowledge of healthcare informatics, patient engagement methodology, and mobile technology applications. The mentorship team will oversee Dr. Diamantidis in her professional development and acquisition of a working understanding of health IT and its application to chronic disease populations. These acquired competencies will enhance her current background in clinical epidemiology. Anticipated results: This Mentored Patient-Oriented Research Career Development Award will help Dr. Diamantidis achieve her immediate and long term goals by supporting: 1) new and unique training in health IT research, 2) multidisciplinary collaboration with expert informatics researchers, 3) advanced training in epidemiology and 4) the generation of critical preliminary data to facilitate her transition to research independence with a specialized niche in implementation of disease-tailored health IT applications in CKD.