试点使用临床决策支持工具来识别有社会需求的患者,并提供导航服务和转介给社区组织:随机对照试验协议
Elham Hatef1,2, Thomas Richards2, Kristin Topel3
1Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States.
JMIR research protocols
|July 23, 2024
概括
本研究评估了一个电子健康记录集成的数字平台,通过闭环推来解决患者的社会需求,旨在通过将个人与社区组织联系起来以获得基本支持服务来改善健康结果.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 健康的社会决定因素 (SDOH) 显著影响健康结果,往往超过医疗保健.
- 通过临床决策支持系统 (CDS) 将SDOH数据集成到电子健康记录 (EHR) 中,对于解决与健康相关的社会需求至关重要.
- 需要应用研究来开发和测试EHR集成的CDS工具和与社区组织 (CBO) 的闭环推系统.
研究的目的:
- 描述一种混合方法研究方案,包括随机对照试验和定性阶段.
- 评估EHR集成数字平台的可行性,可接受性和有效性,以识别和解决患者的社会需求.
- 评估平台提供导航服务和对CBO的闭环转介的能力.
主要方法:
- 一项随机对照试验将招募来自巴尔的摩市社会经济困难社区的590名成年患者.
- 参与者将随机分配到使用数字平台的3个月干预组或接受标准护理的3个月控制组.
- 与医疗保健团队和CBO的重点小组将评估该平台的可行性,可接受性以及对工作流程和患者护理的影响.
主要成果:
- 临床试验正在进行中,注册将从2023年6月开始,预计将于2025年3月完成.
- 初步结果,包括可行性 (每周使用率) 和可接受性 (提供者/患者使用意愿),预计将于2025年春季发布.
- 有效性将通过确定社会需求的变化,提供的导航服务和临床结果 (如住院和急诊室三个月的访问) 来衡量.
结论:
- 该研究预计将提高对社会需求评估和医疗保健和CBO工作流程中的干预数字干预的理解.
- 结果将为未来的多机构试验的开发提供信息,以测试干预措施在各种医疗保健环境中的有效性.
- 该研究旨在改善社会护理在常规临床实践中的整合,以解决健康差异.
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