Hickey Matthew D, Lisker Sarah, Brodie Shauna, Vittinghoff Eric, Russell Marika D, Sarkar Urmimala
1Department of Medicine, University of California San Francisco, School of Medicine, San Francisco, CA 94143 USA.
2Center for Vulnerable Populations, University of California San Francisco, San Francisco, 94110 CA USA.
Pilot Feasibility Stud. 2020 Feb 7;6:16. doi: 10.1186/s40814-020-0552-0. eCollection 2020.
Despite recommendations for monitoring patients with chronic and high-risk conditions, gaps still remain. These gaps are exacerbated in outpatient care, where patients and clinicians face challenges related to care coordination, multiple electronic health records, and extensive follow-up. In addition, low-income and racial/ethnic minority populations that are disproportionately cared for in safety net settings are particularly at risk to lapses in monitoring.
We aim to implement and evaluate a health information technology platform developed using systems engineering methodologies. The implementation is situated in a clinic that monitors patients with head and neck cancer within a large, urban, publicly funded hospital. Our study will evaluate the time it takes for patients to progress through key treatment milestones prior to and after implementation of the tool. We will use models controlling for secular trend to estimate the effect of the tool on improving timely and successful completion of guideline-based care processes.
This protocol details the evaluation of the effectiveness of a human-centered health information technology intervention on improving timely delivery of care for high-risk populations. Other settings, including those that face challenges related to limited resources to devote to safety programs and fragmented health information technology, may benefit from this approach.
ClinicalTrials.gov, NCT03546322. "Customized Registry Tool for Tracking Adherence to Clinical Guidelines for Head and Neck Cancers." Registered 1 June 2018.
尽管有针对慢性和高危疾病患者进行监测的建议，但差距依然存在。在门诊护理中，这些差距进一步加剧，患者和临床医生面临着与护理协调、多个电子健康记录以及广泛随访相关的挑战。此外，在安全网环境中接受不成比例护理的低收入和少数族裔人群尤其面临监测失误的风险。
我们旨在实施和评估一个使用系统工程方法开发的健康信息技术平台。该平台的实施地点是一家大型城市公立医院内的一家监测头颈癌患者的诊所。我们的研究将评估在工具实施前后患者完成关键治疗里程碑所需的时间。我们将使用控制长期趋势的模型来估计该工具对改善基于指南的护理流程的及时和成功完成的效果。
本方案详细介绍了一项以患者为中心的健康信息技术干预措施对改善高危人群护理及时交付效果的评估。其他环境，包括那些面临与用于安全计划的资源有限以及健康信息技术碎片化相关挑战的环境，可能会从这种方法中受益。
ClinicalTrials.gov，NCT03546322。“用于跟踪头颈癌临床指南依从性的定制注册工具”。2018年6月1日注册。
