SBIR 246 - Integrating Patient-Reported Outcomes in Hospice and Palliative

我们的长期目标是开发一种计算机系统，便于使用患者报告的结果(PRO)信息来监控患者状态，并帮助接受姑息治疗和临终关怀的癌症患者做出临床决策。该系统将PRO和其他临床数据与循证治疗指南和路径相结合，以护理和与患者、护理人员和医疗团队之间的协作决策进行交互。该项目将利用我们在其他SBIR工作中开发的用于PRO管理的Adapteval架构，它已经实施了CAT/IRT功能、多个交付平台、突出显示具有临床意义的PRO评分变化的图形报告、警报/提醒机制以及符合CCoW的集成。考虑到项目目标以及我们过去和当前的研发工作，我们定义了如下具体的第一阶段技术目标：1)定义一个缓解/临终关怀模型，以将PRO评估结果与循证路径相结合，以通过文献综述、焦点小组和访谈为临床医生提供临床决策支持，并为患者和照顾者提供教育机会；2)设计一个促进癌症诊所、临终关怀机构和患者之家之间共享PRO相关医疗数据传输的系统架构；3)遵循面向对象和基于知识的软件开发方法开发工作原型；以及4)通过受控试点测试评估原型解决方案的可用性和有用性。预计第一阶段的结果将从实用性和技术角度验证拟议解决方案的可行性，以实现第二阶段的执行和最终商业化。

Our long-term objective is to develop a computer system facilitating the use of patient-reported outcomes (PRO) information to monitor patient status and assist clinical decision making for cancer patients under palliative and hospice care. This system will integrate PRO and other clinical data with evidence-based treatment guidelines and pathways to care and interface with and foster collaborative decision making between the patient, caregivers, and the medical care team. This project will leverage the Adapteval architecture for PRO management developed in our other SBIR efforts, already implementing CAT/IRT capability, multiple delivery platforms, graphical reports highlighting clinically meaningful PRO score changes, alert/reminder mechanisms, and CCOW-compliant integration. Considering the project goals and our past and current R&D efforts, we define the specific Phase I technical objectives as follows: 1) define a palliative/hospice care model to integrate PRO assessment results with evidence-based pathways to provide clinical decision support for clinicians and education opportunities for patients and caregivers via literature review, focus groups, and interviews; 2) design a system architecture facilitating the sharing the transfer of PRO-related medical data between cancer clinics, hospices, and patients' homes; 3) develop a working prototype following object-oriented and knowledge-based software development methodologies; and 4) evaluate the usability and usefulness of the prototype solution via controlled pilot tests. It is expected that Phase I results will validate the feasibility of the proposed solution from the perspectives of both practicality and technology for the purpose of Phase II execution and ultimate commercialization.