eHealth Partnered Evaluation Initiative

 描述(由申请人提供)： 电子健康是提供和接受医疗保健服务的模式，具有不断扩大的证据基础，表明有巨大的潜力增加获得机会，并支持从间歇性护理向持续护理的过渡。在该模型中，患者、他们的家人和临床团队成员使用支持对疾病预防和健康管理至关重要的功能(例如，通信、行为支持、交易)的电子健康技术，而疾病预防和健康管理反过来又影响行为、过程和结果。2016年10月，现有的远程保健办公室和互联保健办公室将合并为一个办公室，监督整个VHA电子保健技术的实施和评估。新合并的联网保健/远程保健办公室将管理现有远程保健办公室(例如临床视频远程保健、家庭远程保健、远程重症监护室)和联网保健办公室(例如患者门户网站、安全消息传递、移动应用程序)以及跨越这些办公室的新技术(例如新的自动远程保健短信系统)中包括的各种技术。认识到严格评估对其使命的重要性，互联健康/远程健康办公室承诺为电子健康合作评估倡议(PEI)提供资金，以支持电子健康技术在整个VHA中的进一步实施，并衡量其对可获得性维度以及退伍军人和临床团队经验、医疗保健流程和退伍军人健康结果的影响。EHealth PEI是在与互联健康/远程健康办公室领导层密切协商后制定的，其拟议目标是：(1)实施患者级别的“支持采用干预”以实现安全消息传递，并通过一项为期一年的快速随机试验评估安全消息传递使用的影响；以及(2)评估VHA向退伍军人和临床团队成员初步推出的自动化远程健康文本消息传递系统。与这两个目标相关的评价工作将以实际、有力的执行和可持续发展模式(PRISM)为指导。正如我们在整个应用程序中讨论的那样，电子健康技术的实施和评估不仅是新的互联健康/远程健康办公室的使命，也是VHA的愿景。除了满足我们运营合作伙伴的需求外，上述目标还与《卓越蓝图》中详述的关键战略和转型行动相对应，并与最近制定的旨在指导互联医疗/远程医疗办公室努力的虚拟接入战略文件保持一致。拟议的电子健康PEI团队包括来自电子健康质量增强研究倡议(QUERI)的领导层和调查人员，他们是信息学、实施科学和混合方法评估方面的公认权威，并与互联健康/远程健康办公室的成员拥有长期的合作关系。

 DESCRIPTION (provided by applicant): eHealth is a model for the delivery and receipt of healthcare services with an expanding evidence base that suggests great potential to increase access and support the transition from episodic to continuous care. In this model, patients, their families, and clinical team members use eHealth technologies that support functions (e.g., communication, behavior support, transactions) that are critical to disease prevention and health management which in turn influences behaviors, processes and outcomes. In October 2016, the existing Office of Telehealth and the Connected Health Office will merge to create a single Office to oversee the implementation and evaluation of eHealth technologies across VHA. The new combined Connected Health/Telehealth Office will manage the full spectrum of technologies included in the current Offices of Telehealth (e.g., clinical video telehealth, home telehealth, tele-ICU) and Connected Health (e.g., patient portal, secure messaging, mobile apps), as well as new technologies that span these offices (such as the new Automated Telehealth Texting System). Recognizing the importance of rigorous evaluation to its mission, the Connected Health/Telehealth Office is pledging funds for an eHealth Partnered Evaluation Initiative (PEI) to support the further implementation of eHealth technologies across VHA, and to measure their impacts on dimensions of access, as well as Veteran and clinical team experiences, healthcare processes, and Veteran health outcomes. Developed in close consultation with Connected Health/Telehealth Office leadership, the proposed objectives of the eHealth PEI are to (1) implement a patient-level "supported adoption intervention" for secure messaging and evaluate the impact of secure messaging use through a rapid, one-year randomized trial; and (2) evaluate the initial rollout of VHA's automated telehealth text messaging system to Veterans and clinical team members. The evaluation work associated with each of these two objectives will be guided by the Practical, Robust Implementation and Sustainability Model (PRISM). As we discuss throughout this application, the implementation and evaluation of eHealth technologies is not just the mission of the new Connected Health/Telehealth Office, it is also the vision of VHA. In addition to addressing the needs of our operational partner, the aforementioned objectives map to key strategies and transformational actions detailed in the Blueprint for Excellence, and align with a recently developed Virtual Access Strategy Document intended to guide the efforts of the Connected Health/Telehealth Office. The proposed eHealth PEI team includes leadership and investigators from the eHealth Quality Enhancement Research Initiative (QUERI) who are recognized authorities in informatics, implementation science, and mixed methods evaluation, and have longstanding, collaborative relationships with constituents in the Connected Health/Telehealth Office.