Electronic Health Record Nudges to Improve Quality of Care in Heart Failure

项目摘要/叙述 这一职业发展奖将为法拉兹·艾哈迈德博士提供成为独立的 内科医生-科学家，开发和实施健康信息技术，增加对 循证治疗和改善心力衰竭患者的生活质量和寿命。艾哈迈德博士 是一位执业的心力衰竭心脏病专家和信息学家，目前的研究重点是 整合不同的电子健康数据以衡量护理质量。该奖项将在以下方面提供严格的培训 传播和实施科学、临床决策支持和实用临床试验方法论 这将使他能够设计和测试数字干预措施，以提高医疗质量。培训计划 包括发展领导跨学科团队和指导所需的独立调查人员技能 下一代生物医学信息学和实施科学研究人员。他将实现这些目标 通过全面的培训计划实现职业目标，该计划结合了密集的指导、正式的 课程、研讨会、会议和体验式学习。他的主要导师是Abel Kho博士，一位专家 在生物医学信息学、电子临床决策支持工具和质量改进方面具有广泛的 指导记录。此外，心血管流行病学的领军人物之一唐纳德·劳埃德·琼斯博士 拥有模范导师记录，将担任共同导师并监督艾哈迈德博士在 成为一名多产、独立的内科科学家的必备技能。最后，共同导师J.D.史密斯博士，一个 既定的导师和实施科学方法论专家，将提供务实试验方面的专业知识 方法论。西北大学丰富的资源环境将有助于这一项目的成功 拟议的培训和研究项目，包括：1)医学部的专门支助 和健康信息伙伴关系中心；2)由导师、顾问和 合作者；3)广泛的技能课程、研讨会和研讨会4)研究基础设施，包括 世界一流的集成西北医学电子数据仓库、数据分析和生物统计 支持；以及5)来自大型综合学术健康中心和西北医学质量中心的支持 创新中心。这项研究的总体目的是对一组临床决策支持微调进行试点测试 推动临床医生增加心脏病患者的循证治疗处方和滴定 射血分数降低的衰竭，这是一种高度病态、流行和代价高昂的疾病，在 护理质量。具体目标一将评估心力衰竭患者高质量护理的障碍和 在小学阶段通过混合方法确定理想医疗信息技术工具的组成部分 护理和心脏病学实践。具体目标二将评估在合作设计中开发的一组轻推 与主要利益相关者共同举办研讨会。具体目标三将在试点中测试这组轻推的可行性 可行性试验。

PROJECT SUMMARY/NARRATIVE This career development award will provide Dr. Faraz Ahmad with the opportunity to become an independent physician-scientist who develops and implements health information technologies that increase the uptake of evidence-based therapies and improve the quality of life and longevity for patients with heart failure. Dr. Ahmad is a practicing heart failure cardiologist and informaticist with a current research focus on the methodology of integrating diverse electronic health data to measure quality of care. This award will provide rigorous training in dissemination and implementation science, clinical decision support, and pragmatic clinical trial methodology that will enable him to design and test digital interventions to improve care quality. The training program includes the development of independent investigator skills required to lead interdisciplinary teams and mentor the next-generation of biomedical informatics and implementation science researchers. He will achieve these career goals through a comprehensive training program that combines intensive mentorship, formal coursework, workshops, conferences, and experiential learning. His primary mentor is Dr. Abel Kho, an expert in biomedical informatics, electronic clinical decision support tools, and quality improvement with an extensive record of mentoring. In addition, Dr. Donald Lloyd-Jones, one of the leaders in cardiovascular epidemiology with an exemplary mentorship record, will serve as a co-mentor and oversee Dr. Ahmad’s training in the essential skills of becoming a productive, independent physician-scientist. Finally, co-mentor Dr. J.D. Smith, an established mentor and implementation science methodologist, will provide expertise in pragmatic trial methodology. The rich resource environment of Northwestern University will facilitate the success of this proposed training and research project and includes: 1) dedicated support from the Department of Medicine and the Center for Health Information Partnerships; 2) an interdisciplinary team of mentors, advisors, and collaborators; 3) extensive skill courses, workshops, and seminars 4) research infrastructure including the world class, integrated Northwestern Medicine Electronic Data Warehouse, data analytics, and biostatistical support; and 5) support from a large, integrated academic health center and the Northwestern Medicine Quality Innovation Center. The overall purpose of the research is to pilot test a set of clinical decision support nudges to push clinicians to increase prescription and titration of evidence-based therapies for patients with heart failure with reduced ejection fraction, a highly morbid, prevalent, and costly condition with enormous gaps in quality of care. Specific Aim One will evaluate barriers to high quality of care for patients with heart failure and identify components of an ideal health information technology tool via a mixed methods approach in primary care and cardiology practices. Specific Aim Two will evaluate a set of nudges developed in a co-design workshop with key stakeholders. Specific Aim Three will test the feasibility of the set of nudges in a pilot feasibility trial.