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

项目摘要/摘要 该项目调查患者到提供者家庭视频会诊的实用性和成本效益， 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)。尽管T1D的治疗方案在过去十年里有了显著的进步， 在这段时间内，患有T1D的青年患者的血糖控制措施并没有改善。这一差距是 当前治疗的潜在疗效及其在临床人群中的有效性表明有必要 改善了护理服务的提供。当前提供的安全、符合HIPAA标准的视频会议平台 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 具有互联网、蓝牙和音频-视频功能的设备-提供了开发创新的机会 提供T1D护理的新模式。该提案将通过以下具体的方式调查两个这样的模型 目标：目标1-进行一项随机试验，以评估以家庭为基础的补充视频访问对 T1D和次优儿童患者的血糖控制、医疗利用和患者体验 血糖控制。目标2-建立儿科补充家庭视频访视的成本效益模型 血糖控制不佳的T1D患者。目标3--评估远程监测的可行性--包括 自动分析患者生成的糖尿病数据，以确定面对面访问之间的高危指标 -适用于患有T1D的儿科患者。这项研究的长期目标是确定远程医疗技术如何 可以最好地用于补充面对面护理，以改善患者体验、成本效益、 以及儿童T1D患者的健康结局。在完成这些研究目标的同时， 应聘者将参加个性化的学习课程，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，以患者为中心的护理提供， 以及领导力和指导。这次培训，再加上优秀的导师团队和强大的 机构支持，将使候选人处于理想的地位，以便随后竞争独立研究 R01级别的资金，并将自己确立为远程医疗技术领域的领先研究人员 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.