在一个负责任的护理组织部署数字预先护理计划平台
R Lynae Roberts1, Desh P Mohan2, Katelin D Cherry2
1From the Koda Health, Houston, TX, USA (RLR, DPM, KDC, SS, TRH, CL, AC, DH, TYF); Population Health, Houston Methodist Coordinated Care Accountable Care Organization, Houston, TX (ZKM, JDA); Weill Cornell Medical College, New York, NY (JDA); Houston Methodist, Department of Medicine, Houston TX (JDA). rlroberts918@gmail.com.
数字工具可以提高预先护理计划 (ACP) 的采用率. 一项试点研究显示,超过一半的患者使用Koda Health完成了他们的ACP,他们更喜欢在家护理和有限的生命支持.
科学领域:
- 数字健康数字健康
- 医学伦理 医学伦理
- 公共卫生 公共卫生
背景情况:
- 提前护理计划 (ACP) 可以提高生活质量,降低医疗保健成本,但由于知识差距和讨论困难,采用率很低.
- 数字工具提供了一种潜在的解决方案,可以克服启动和完成预先护理计划的障碍.
- 以患者为中心的医疗保健强调尊重个人价值观和对未来医疗治疗的偏好.
研究的目的:
- 评估数字工具 (Koda Health) 在促进患者预先护理计划 (ACP) 的有效性.
- 评估患者参与和决策,在ACP数字平台上进行质量改进.
- 识别不同人口群体在ACP完成和偏好方面的潜在差异.
主要方法:
- 从Koda Health的面向患者的ACP工具中对试点部署数据的回顾性分析.
- 包括由护士导航员转介的休斯顿卫理会协调护理的患者.
- 衡量在平台上记录的使用率,完成率和特定的终生治疗偏好.
主要成果:
- 超过一半 (52.7%) 符合条件的患者自愿使用数字工具完成了他们的预先护理计划.
- 患者主要喜欢在家进行终身护理 (66.4%),并且一般不希望进行生命支持干预 (51-71%).
- 虽然大多数生命支持决策在人口统计学上是相似的,但与白人患者相比,黑人患者对CPR和透析的试验干预的偏好更高.
结论:
- 像Koda Health这样的数字健康工具可以有效地增加获得预先护理规划的机会,促进公平.
- 这些发现支持使用数字平台来帮助卫生系统和提供者提供全面的ACP.
- 需要进一步的研究来评估ACP对随后医疗保健利用的影响.
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