Using an EMR to Improve Urban Child Health

描述（由申请人提供）：候选人是一名儿科医生，流行病学家和国家医学图书馆的应用信息学研究员。他的主要职业目标是使用基于计算机的技术，如电子病历（EMR），提高城市儿科初级保健的质量。利用波士顿大学医学院、社区健康中心健康网协作组织和国家儿童医疗保健质量倡议组织在波士顿提供的资源，他建议花三年时间评估使用EMR技术提高儿科医疗保健质量的战略。他的重点将放在两个领域的核心重要性，初级保健临床预防服务和哮喘的护理。 本项目的具体目标是在城市初级保健中心网络中使用一个共同的电子病历：1）描述基于电子病历的城市儿童和青少年初级保健的内容和质量; 2）评估证据增强审计和反馈的有效性，以改善多种初级保健服务的提供（预防服务和哮喘护理）; 3）描述初级保健临床医生的看法和质量改进策略后，收到基于实践的审计和反馈; 4）评价增加床旁决策支持后质量的增量改善，以改善多种初级保健服务（预防服务和哮喘护理）的提供; 5）描述接受床旁决策支持后初级保健临床医生的看法。这些研究建立在候选人在儿科EMR软件开发和评估方面的六年经验基础上。 长期职业目标是领导波士顿市的合作研究网络，开发，使用和评估基于技术的解决方案（包括EMR），以改善城市儿童的健康和医疗保健。

DESCRIPTION (provided by the applicant): The candidate is a pediatrician, epidemiologist, and an applied informatics fellow with the National Library of Medicine. His primary career objective is to improve the quality of urban pediatric primary care using computer-based technologies such as the electronic medical record (EMR). Using resources available in Boston through the Boston University School of Medicine, the Neighborhood Health Center Healthnet Collaboration, and the National Initiative for Child Healthcare Quality, he proposes to spend three years evaluating strategies to improve the quality of pediatric health care using EMR technologies. His focus will be in two areas of central importance to the primary care clinician-preventive services and the care of asthma. The specific aims of this project are to use a common EMR in a network of urban primary care centers to: 1) describe the content and quality of EMR-based urban child and adolescent primary care; 2) evaluate the efficacy of evidence-enhanced audit and feedback to improve the delivery of multiple primary care services (preventive services and asthma care); 3) describe the perceptions of primary care clinicians and quality improvement strategies used following receipt of practice-based audit and feedback; 4) evaluate incremental improvements in quality following the addition of point-of-care decision support to improve the delivery of multiple primary care services (preventive services and asthma care); and 5) describe the perceptions of primary care clinicians following receipt of point-of-care decision support. These studies build on the candidate's six years of experience in the development and evaluation of pediatric EMR software. The long-term career objectives are to lead a collaborative research network in the City of Boston that will develop, use, and evaluate technology-based solutions (including the EMR) to improve the health and healthcare of urban children.