ACO/Public Health Collaborative Preventive Care Delivery to Priority Populations

项目摘要/摘要 该项目的长期目标是：1)减少儿童中疫苗可预防的疾病， 青少年和成年人，通过加强执行免疫做法咨询委员会 免疫接种建议和2)创建区域协作保健之间的协作框架 科罗拉多州的组织(RCCO)，负责照顾医疗补助和科罗拉多州健康保险覆盖的患者 部门的免疫信息系统(CIIS)，用于提供预防保健服务。在一个 新的RCCO-公共卫生(RCCO-PH)合作研究小组将实施和测试基于证据的 使用我们以前开发的提醒/召回来增加免疫接种的集中方法 一群人。评价将在概念上以重新瞄准框架为指导。在第一年，(具体目标1) 将建立RCCO数据库和CIIS之间的连接，并完善协作干预 在RCCO服务的社区中，来自主要利益相关者、提供者和患者的意见。在.期间 第二年和第三年(具体目标2)，将进行务实试验，以评估有效性和 RCCO-PH协作集中化方法与基于实践的方法的成本效益比较 提高儿童和青少年免疫接种率的方法。在研究此方法时，请参阅 对于儿童人群，我们将与RCCOs合作，在CIIS中填充成人免疫记录，并 建立上传成人免疫数据的系统(具体目标3)。在第三年(具体目标4)，我们将 将协作集中提醒/召回方法扩展到扶轮社内的成人人口，并 再进行一次务实的试验。最后，在第5年(具体目标5)，我们将检查以下模型 RCCO-公共卫生协作框架的可持续性。我们的传播计划将包括直接 扩展到科罗拉多州的其他5个RCCO以及其他国家责任关怀组织，地方 以及国家实践和政策组织，开发关于集中协作交付的工具包 方法和我们由AHRQ资助的国家实施科学和预防研究中心 (清脆)。该研究将提供关于集中式协作的可行性和有效性的数据 提醒/召回和关于ACO和公共卫生合作，这将与建立 在全国范围内开展这样的合作。此协作创建的技术和管理基础设施将 作为一个平台，可以在当地建立协作提供其他临床预防服务的平台 全国范围内。这项研究涉及多个AHRQ R18投资组合的研究领域，包括比较 有效性、保健信息技术和预防和护理管理组合， 全部在AHRQ优先人群中。

Project Summary/Abstract The long-term objectives of this project are to 1) decrease vaccine-preventable diseases among children, adolescents and adults by increasing implementation of the Advisory Committee on Immunization Practices' immunization recommendations and 2) create a collaborative framework between regional care collaborative organizations (RCCO) in Colorado that care for patients covered by Medicaid and the Colorado State Health Department's Immunization Information System (CIIS) for the delivery of preventive care services. Within a new RCCO-public health (RCCO-PH) collaborative the study team will implement and test an evidence-based centralized method of increasing immunization delivery using reminder/recall previously developed by our group. The evaluation will be conceptually guided by the Re-Aim framework. During year one, (Specific Aim 1) connectivity between RCCO databases and CIIS will be established and the collaborative intervention refined with input from key stakeholders, providers and patients in the communities served by the RCCO. During the second and third year (Specific Aim 2), a pragmatic trial will be conducted to assess the effectiveness and cost-effectiveness of the RCCO-PH collaborative centralized approach compared with a practice-based approach for increasing immunization rates in children and adolescents. While studying this approach in pediatric populations, we will work with the RCCOs to populate CIIS with adult immunization records and to create systems for the uploading of adult immunization data (Specific Aim 3). In year 3 (Specific Aim 4) we will extend the collaborative centralized reminder/recall approach to adult populations within the RCCOs and conduct an additional pragmatic trial. Finally, in year 5, (Specific Aim 5) we will examine models for sustainability of the RCCO-Public Health collaborative framework. Our Dissemination Plan will include direct extension to the other 5 RCCO's in Colorado as well as other national accountable care organizations, local and national practice and policy organizations, development of a toolkit about centralized collaborative delivery methods and our AHRQ-funded national Center for Research in Implementation Science and Prevention (CRISP). The study will provide data about the feasibility and effectiveness of centralized collaborative reminder/recall and about ACO and public health collaboration that will be highly relevant to efforts to build such collaborations nationally. The technical and administrative infrastructure created by this collaboration will be a platform on which the collaborative delivery of other clinical preventive services can be built locally and nationally. The study addresses research areas in multiple AHRQ R18 portfolios including the Comparative Effectiveness, the Health Information Technology and the Prevention and Care Management Portfolios, all within AHRQ priority populations.