IBDPROMISE: A Web-based Patient-centric Model to Improve Quality and Outcomes

Summary

Principal Investigator: Ashish Atreja
Abstract: PROJECT SUMMARY Background: Measuring and improving healthcare quality is an important national challenge. The discussion about quality and disease management rarely happens during office visits when patients and providers have a unique opportunity to listen to each other and make collaborative decisions. Hypothesis: Encouraging patients to proactively measure and improve quality can bring remarkable efficiency, effectiveness and cost-savings to quality improvement efforts. Goal: To acquire skills to design and evaluate a patient-centric model, IBDPROMISE (IBD Patient Reported Outcomes and Medical IIlness Severity Evaluation), in which patients with inflammatory bowel disease (IBD) measure their quality of care metrics (such as colonoscopy surveillance) as well as quality of life in waiting rooms and at home;and physicians use this information at the point of care for quality improvement efforts. The specific aims of the project are: " AIM I. Define a set of comprehensive quality of care metrics (such as immunization, appropriate colonoscopy surveillance) for IBD patients from national recommendations. " AIM II. Measure longitudinally quality of care metrics and quality of life (QOL). " AIM III. Conduct a randomized controlled trial to determine the impact of IBDPROMISE in improving outcomes (quality of care, quality of life, patient adherence, disease control and resource utilization). Methods: All eligible adult patients arriving in Mount Sinai Hospital IBD center and a community site during study recruitment will be offered tablet-based questionnaire in waiting rooms and enrolled once consented. After a baseline period (at least six months), participants in the IBDPROMISE arm will be asked to report their quality of care metrics and QOL every month for 18 months. This will generate an electronic health card (detailing disease summary, quality metrics and a graph showing the trend of QOL and healthcare utilization over time). Patients and providers will use the health card, active decision support (a drop in scores) and passive decision support (quality dashboards and reminders) to improve the quality of care collaboratively. Outcome: The primary end-point of the study is the proportion of patients in each group (IBDPROMISE vs. control) who meet all eligible quality metrics at week 104. Secondary endpoints will be comparison of quality of life, disease control rates and utilization of healthcare resources between the two arms. Additional analysis will be done to determine the impact of demographics, socioeconomic status and computer literacy on IBDPROMISE adoption and improvement in outcomes. Future Direction: This project will help me acquire critical skills in self-management, quality improvement, design of clinical trials and analysis of quality of life data and cost effectiveness. In the future, IBDPROMISE and its point of care QI model within EHR, if proven successful, will be made available license-free to other academic institutions, and help me implement multi-site clinical trials and prospective cohort studies in IBD.
Funding Period: -----------------201 - ----------------2018
more information: NIH RePORT

Research Grants

Detail Information

Research Grants31

  1. The Shelf Live Evaluation of Investigational Dosage Forms
    Jonathan White; Fiscal Year: 2013
    ..This contract is essential for continued assurance of the quality of drugs undergoing clinical investigation for different types of cancer by Cancer Therapeutics Evaluation Program. ..
  2. Caloric Restricted Rodent Colony
    RICK MORIN; Fiscal Year: 2013
    ..The purpose of this project is to develop, maintain and distribute a standing colony ofaged, calorically restricted rodents ofdefined strains for use by investigators in studies of aging. ..
  3. Notch-Mediated Expansion of Cord Blood Progenitors for Stem Cell Transplant
    Colleen Delaney; Fiscal Year: 2013
    ..Our goal is to now determine the clinical efficacy of this approach in a phase II clinical trial. ..
  4. Mexican Children of Immigrants Program
    Nancy S Landale; Fiscal Year: 2013
    ..The proposed research will produce essential knowledge for the development of sound public policies and interventions to reduce health disparities. ..
  5. Southwest Center for Agricultural Health, Injury Prevention, and Education
    Jeffrey L Levin; Fiscal Year: 2013
    ..The Center's impact will be expanded by a Feasibilty program that augments the proposed scope of work and is responsive to emerging issues. ..
  6. Case GI SPORE
    Sanford D Markowitz; Fiscal Year: 2013
    ..The strength of these investigators and the resources at their disposal will ensure this program leads to important advances. ..
  7. University of Maryland Greenebaum Cancer Center Support Grant
    Kevin J Cullen; Fiscal Year: 2013
    ..Reflecting our remarkable and continued growth, UMGCC seeks to renew its CCSG to enhance and expand its efforts in high-quality and clinically relevant cancer research. ..
  8. DNA Polymerase Fidelity Mechanisms: Theory and Experiment
    MYRON GOODMAN; Fiscal Year: 2013
    ..abstract_text> ..
  9. Mid-South Trandisciplinary Collaborative Center for Health Disparities Research
    Mona N Fouad; Fiscal Year: 2013
    ..Aim 4. Implement a pilot project program, including a career development component;Aim 5. Evaluate the research, implementation, and dissemination activities of the TCC. ..
  10. BIOLOGY OF NEUROENDOCRINE PEPTIDES
    Marc R Montminy; Fiscal Year: 2013
    ..Specifying the contributions of the CRF family of ligands and receptors to the maintenance of homeostasis and to stress-linked allostasis may improve our ability to manage diseases, including mood and metabolic disorders ..
  11. SCHS, mitochondria, healthy aging and longevity
    Gino A Cortopassi; Fiscal Year: 2013
    ..abstract_text> ..
  12. COBRE Center for Central Nervous System Function
    Jerome N Sanes; Fiscal Year: 2013
    ..The COBRE Center will leverage the administrative resources available through the Brown Institute for Brain Science to ensure efficient operation and coordinate with other brain science research activities at Brown. ..
  13. NUCLEAR STRUCTURE AND GENE EXPRESSION
    Janet L Stein; Fiscal Year: 2013
    ..abstract_text> ..
  14. Hopkins Center for Eliminate Cardiovascular Health Disparities
    Lisa A Cooper; Fiscal Year: 2013
    ..abstract_text> ..
  15. STUDIES OF JOINT AGING AND OSTEOARTHRITIS
    Martin K Lotz; Fiscal Year: 2013
    ..Sah) will analyze biomechanical mechanisms of early and advanced cartilage degeneration and determine consequences for chondrocyte function and survival. ..
  16. IL-13 and IL-17 dynamics in the asthmatic airway
    Dean Sheppard; Fiscal Year: 2013
    ..RELEVANCE: Epithelial cells line the airways and play an important role in asthma. Micro-RNAs regulate gene expression. We will identify the nature, causes and consequences of changes in airway epithelial cell micro-RNAs in asthma. ..
  17. Substance Abuse Research - Medications Development Center
    JOY MARIE SCHMITZ; Fiscal Year: 2013
    ..abstract_text> ..