Use of connected health technology to optimize outcomes for high risk pediatric patients with type 1 diabetes

项目总结/摘要 该项目调查了患者对提供者基于家庭的视频会面的效用和成本效益， 以及远程监测患者收集的儿童和青少年健康数据的可行性， 1型糖尿病（T1D）。虽然T1D的治疗选择在过去十年中有了显著的进步， 在这段时间内，T1D青少年的血糖控制措施没有改善。这种差距， 当前治疗的潜在功效及其在临床人群中的有效性说明了需要 改善护理服务。当前可用于视频会议的安全、符合HIPAA的平台 以及患者和提供者之间的远程数据共享-结合广泛的患者访问"智能 设备"与互联网，蓝牙和音频视频功能-提供了机会，开发创新的 提供T1D护理的新模式。本提案将通过以下具体内容研究两种此类模型： 目的：目的1-进行一项随机试验，以评估补充家庭视频访问对 T1D和次优儿童患者的血糖控制、医疗保健利用和患者经验 血糖控制目的2-模拟儿科补充家庭视频访视的成本效益 血糖控制欠佳的T1D患者。目标3-评估远程监控的可行性-包括 对患者生成的糖尿病数据进行自动分析，以识别面对面访视之间的高风险指标 - 儿童T1D患者。这项研究的长期目标是确定远程医疗技术如何 可以最好地用于以改善患者体验、成本效益 儿童T1D患者的健康状况。在完成这些研究目标的同时， 候选人将进行个性化的学习课程，以获得健康领域的关键技能 信息学，成本效益分析，心理测量学和调查方法，以病人为中心的护理服务， 领导力和指导力。本次培训，结合优秀的导师团队和强大的 机构的支持，将定位候选人理想的竞争，随后的独立研究 在R01级的资金，并建立自己作为一个领先的研究人员在竞技场的远程医疗技术 用于儿科T1D管理。

PROJECT SUMMARY / ABSTRACT This project investigates the utility and cost-effectiveness of patient-to-provider home-based video encounters, as well as the feasibility of remote monitoring of patient-collected health data for children and adolescents with type 1 diabetes (T1D). Although therapeutic options for T1D have advanced phenomenally in the last decade, measures of glycemic control in youth with T1D have not improved over this time frame. This gap between the potential efficacy of current treatments and their effectiveness in the clinical population illustrates a need for improved delivery of care. The current availability of secure, HIPAA-compliant platforms for video conferencing and remote data-sharing between patients and providers – combined with widespread patient access to “smart devices” with internet, Bluetooth and audio-video capabilities – presents the opportunity to develop innovative new models for delivery of T1D care. This proposal will investigate two such models via the following Specific Aims: AIM 1 – Conduct a randomized trial to evaluate the impact of supplemental home-based video visits on glycemic control, healthcare utilization, and patient experience for pediatric patients with T1D and suboptimal glycemic control. AIM 2 – Model the cost-effectiveness of supplemental home-based video visits for pediatric T1D patients with suboptimal glycemic control. AIM 3 – Evaluate the feasibility of remote monitoring – including automated analysis of patient-generated diabetes data to identify high-risk indicators between in-person visits – for pediatric patients with T1D. The long-term goal of this research is to establish how telehealth technology can best be used to supplement in-person care in ways that improve patient experience, cost-effectiveness, and health outcomes for pediatric patients with T1D. In parallel to completion of these research aims, the candidate will undertake an individualized course of study to attain key skills in the arenas of health informatics, cost-effectiveness analysis, psychometrics and survey methods, patient-centered care delivery, and leadership and mentoring. This training, in combination with an outstanding mentorship team and strong institutional support, will position the candidate ideally to compete subsequently for independent research funding at an R01 level, and to establish herself as a leading researcher in the arena of telehealth technology for pediatric T1D management.