Safe and Equitable Telehealth for Chronic Conditions (SafE-T C2) Learning Laboratory

摘要 拟议研究的目标是开发一个患者安全学习实验室， 与远程医疗（同步视频和电话访问）相关的突出患者安全问题，重点是 在慢性病患者身上，设计、开发、实施和评估新的安全解决方案。的 安全和公平的远程医疗慢性病（SafE-T C2）学习实验室解决了许多 医疗保健研究和质量机构的优先事项，并将专注于提高安全性，质量和价值， 健康护理该实验室将解决慢性病、健康公平和弱势群体问题， 初级保健.学习实验室的基础是一个社会技术系统工程框架 考虑了可能导致患者安全问题的多种因素，包括技术，人员， 过程和政策。目标1是问题分析阶段，将采用多管齐下的方法， 确定与远程保健有关的患者安全问题。目标2是解决方案设计和开发阶段。在这 在第一阶段，包括行业合作伙伴在内的各种利益攸关方将共同设计和开发安全解决方案。 目标3是实施和评估阶段。开发的解决方案将在不同的 多个医疗保健系统的门诊诊所以及过程测量和结果测量将 用于确定解决方案在解决预期患者安全问题方面的有效性。 这项研究工作是MedStar Health、斯坦福大学医疗保健和 山间医疗该项目利用了多样化研究团队的广泛专业知识， 包括系统工程师和人为因素专家，健康公平研究人员，临床医生和操作人员。 领导者、数据科学家和临床应用开发人员以及实施科学家。实验室 还包括行业合作伙伴，健康公平咨询团队，健康公平社区咨询委员会， 一个病人和家庭咨询委员会，将告知该项目的各个方面。 这项研究的贡献将包括识别突出的安全问题，开发和 实施可在不同医疗机构中扩展的安全解决方案，以及新知识 其中安全解决方案对提高远程保健安全性最为有效。我们严格的传播计划 包括将结果传达给政策制定者和倡导团体、临床领导人和其他 组织，以改善临床实践，以及学术观众。将提供结果 在项目开始后的4-6个月内，我们将在整个拟议的 四年计划。

ABSTRACT The objective of the proposed research is to develop a patient safety learning laboratory that will identify prominent patient safety issues associated with telehealth (synchronous video and phone visits), with a focus on patients with chronic conditions, and design, develop, implement, and evaluate novel safety solutions. The Safe and Equitable Telehealth for Chronic Conditions (SafE-T C2) learning laboratory addresses numerous Agency for Healthcare Research and Quality priorities and will focus on improving safety, quality, and value of healthcare. The laboratory will address chronic conditions, health equity and vulnerable populations, and primary care. At the foundation of the learning laboratory is a socio-technical system engineering framework that considers multiple factors that may contribute to patient safety issues including technology, people, processes, and policies. Aim 1 is the problem analysis phase and a multipronged approach will be used to identify telehealth related patient safety issues. Aim 2 is the solution design and development phase. In this phase a diverse set of stakeholders, including industry partners, will co-design and develop safety solutions. Aim 3 is the implementation and evaluation phase. Developed solutions will be implemented in different outpatient clinics across multiple healthcare systems and process measures and outcome measures will be used to determine effectiveness of the solutions in addressing the intended patient safety issues. The research effort is a unique collaboration between MedStar Health, Stanford Health Care, and Intermountain Healthcare. This project utilizes the extensive expertise of the diverse research team which includes system engineers and human factors experts, health equity researchers, clinicians and operational leaders, data scientists and clinical application developers, as well as implementation scientists. The laboratory also includes industry partners, a health equity advisory team, a health equity community advisory board, and a patient and family advisory board that will inform all aspects of the project. Contributions from this research will include identification of prominent safety issues, development and implementation of safety solutions that can be scaled across different healthcare facilities, and new knowledge of which safety solutions are most effective to improving telehealth safety. Our rigorous dissemination plan includes communication of results to policymakers and advocacy groups, clinical leaders and other organizations that serve to improve clinical practice, as well as academic audiences. Results will be available within 4-6 months of project start and we will disseminate our findings throughout the course of the proposed four-year project.