This Project Grant award, funded by the Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes (CFDA 93.226) program, will evaluate the impact of three EHR-optimization interventions on primary care physician (PCP) well-being, EHR time, and patient care quality and utilization. The interventions include: 1) scribes, 2) advanced team-based inbox messaging support, and 3) AI-assisted inbox messaging support. The $1,199,999 award to Brigham...
This federal Project Grant award from the Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes (CFDA 93.226) program provides $172,785 to the University of Rochester to develop machine learning (ML)-based clinical decision support (CDS) tools to predict future laboratory values and reduce laboratory overutilization in pediatric intensive care units (PICUs). The project, titled "ML-ROVER: Machine Learning to Reduce Laboratory Test...
This Project Grant award from the Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes (CFDA 93.226) program will provide $275,000 in funding to the University of Texas Health Science Center at Houston from August 1, 2024 to July 31, 2026. The project aims to develop and test strategies to increase implementation of evidence-based interventions through collaboration with patient advocacy groups in the areas of juvenile idiopathic...
This Project Grant award of $3,024,414.00 from the National Center for Advancing Translational Sciences (NCATS), under CFDA Program 93.350, aims to establish a library of "out of the box" quality improvement (QI) templates that translate clinical guidelines into care delivery. The grantee, Phrase Health, Inc., will develop QI templates for the inpatient management of four diseases tied to the Hospital Readmissions Reduction Program (HRRP): pneumonia, congestive heart failure, chronic...
This Project Grant award from the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) under the CFDA 93.226 Research on Healthcare Costs, Quality and Outcomes program is funding the development and testing of a clinical decision support (CDS) tool to improve iron deficiency screening and management for pregnant individuals at high risk of postpartum hemorrhage (PPH). Specifically, the $118,089 award will support a two-phase project at Massachusetts...
This Project Grant award, funded by the Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes (CFDA 93.226) program, supports a comprehensive $398,972 study on improving healthcare quality and equity for newborns with prenatal substance exposure. The study, conducted by the University of California, Davis in collaboration with the Better Outcomes through Research for Newborns (BORN) network and the EMPOWER stakeholder group, aims to:...
This $729,821 Project Grant award from the National Institute of Environmental Health Sciences (NIEHS) under the Medical Library Assistance (CFDA 93.879) program supports the development of artificial intelligence (AI) and machine learning (ML) methods for real-time monitoring and updating of clinical decision support (CDS) systems. The goal is to reduce health disparities that may arise from the use of CDS tools. The key products of this work include: Fair ML models trained on retrospective...
This Project Grant award from the Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes program (CFDA 93.226) provides $800,000 to disseminate a virtual facilitation workshop to antimicrobial stewardship program (ASP) teams and surgeons at 20 U.S. children's hospitals. The goal is to aid in de-implementing unnecessary post-operative antibiotic use in children, while assessing implementation outcomes and clinical impacts such as surgical...
This $385,877 federal Project Grant award from the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) under the Research on Healthcare Costs, Quality and Outcomes (CFDA 93.226) program aims to optimize the integration of child psychosocial screenings in primary care. The grant will fund the development and testing of the CareLoop intervention, which uses process service mapping to enhance referral and linkage pathways and promote whole-person,...
This $475,788 Project Grant from the Department of Health and Human Services National Institutes of Health National Institute of General Medical Sciences will support the development of automated clinical decision support tools for summarizing cardiac data. Specifically, the University of Central Oklahoma and collaborators at Baylor College of Medicine and Texas Children's Hospital will apply deep learning and subset selection techniques to classify and summarize electrocardiogram and...
MULTI-INSTITUTIONAL IMPLEMENTATION OF QUALITY DECISIONS: A CLINICAL DECISION SUPPORT ANALYTICS TOOL TO DRIVE OUTCOMES - PROJECT SUMMARY/ABSTRACT PHRASE HEALTH IS A CLINICAL DECISION SUPPORT (CDS) ANALYTICS COMPANY THAT EMPOWERS HEALTH SYSTEMS TO DELIVER HIGH VALUE CLINICAL CARE THROUGH DATA-DRIVEN IMPROVEMENTS OF CDS. CDS ENHANCES HEALTH-RELATED DECISIONS AND ACTIONS WITH PERTINENT, ORGANIZED CLINICAL KNOWLEDGE, AND PATIENT INFORMATION. FOR EXAMPLE, PHYSICIANS MAY HAVE TROUBLE REMEMBERING TO ORDER ALL GUIDELINE-RECOMMENDED CARE FOR SEPSIS. CDS DELIVERED VIA AN ORDER SET IN THE ELECTRONIC HEALTH RECORD (EHR) CAN SIMPLIFY THIS PROCESS AND REDUCE MORTALITY BY BUNDLING THE RECOMMENDED DIAGNOSTIC AND THERAPEUTIC ORDERS TOGETHER. HOWEVER, CDS MAY FAIL TO IMPROVE OUTCOMES BECAUSE: (1) THE CDS TOOL IS UNDERUTILIZED; (2) THE USER MAY NOT FOLLOW THE RECOMMENDED ACTION FROM THE CDS; (3) THE RECOMMENDED ACTION MAY NOT LEAD TO THE APPROPRIATE EVIDENCE-BASED PRACTICE (EBP); AND/OR (4) THE EBP MAY NOT TRANSLATE TO THE EXPECTED OUTCOME IN A NOVEL POPULATION. HEALTHCARE ORGANIZATIONS NEED AN EFFICIENT, RIGOROUS, AND SCALABLE PROCESS EVALUATION METHOD TO DIAGNOSE WHEN AND WHY CDS IS NOT LEADING TO THE INTENDED IMPROVEMENTS. IN PHASE 1, OUR TEAM DEMONSTRATED THE TECHNICAL FEASIBILITY AND USABILITY OF A NEW SOFTWARE PRODUCT, QUALITY DECISIONS, THAT GUIDES QUALITY IMPROVEMENT (QI) ADVOCATES OF ALL EXPERIENCE LEVELS TO (1) RIGOROUSLY EVALUATE THE IMPACT OF CDS ON CLINICAL OUTCOMES AND (2) CONVERT DATA-DRIVEN INSIGHTS INTO ACTION. IN THIS PHASE 2 PROPOSAL, WE WILL USE THE RE-AIM FRAMEWORK TO EVALUATE IMPLEMENTATION OF QUALITY DECISIONS AT THREE DIVERSE HEALTH SYSTEMS (CHILDREN'S HEALTHCARE OF ATLANTA, CHILDREN'S HOSPITAL OF PHILADELPHIA, AND THE UNIVERSITY OF VERMONT HEALTH NETWORK). IN AIM 1 OF THIS PROPOSAL, WE WILL EVALUATE THE IMPLEMENTATION EFFECTIVENESS OF QUALITY DECISIONS. OUR PRIMARY OUTCOME WILL BE HOW OFTEN THE SOFTWARE LEADS TO (1) NEW QI OR CDS INTERVENTION(S), (2) INCREASED CONFIDENCE IN CDS EFFECTIVENESS, OR (3) CHANGES IN COHORT OR MEASURE DEFINITIONS. USING MIXED METHODS INCLUDING SURVEYS, LOG DATA, AND FOCUS GROUPS, WE WILL EVALUATE IMPLEMENTATION EFFICACY, ADOPTION, AND FIDELITY. WE WILL ALSO ASSESS IMPLEMENTATION BARRIERS AND FACILITATORS USING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH. IN AIM 2, WE WILL DETERMINE THE CUSTOMER RESOURCES REQUIRED TO IMPLEMENT QUALITY DECISIONS AT SCALE. IN A PILOT PHASE, EACH HEALTH SYSTEM WILL IMPLEMENT THE SOFTWARE FOR A LIMITED NUMBER OF CPGS AND COLLECT HOURS OF WORK REQUIRED TO GET THE SOFTWARE UP AND RUNNING. IN AN EXPANSION PHASE, WE WILL ESTIMATE THE NUMBER OF INSTITUTIONAL CPGS THAT COULD FEASIBLY BE INCORPORATED INTO THE SOFTWARE AND THE NUMBER ACTUALLY BUILT IN ONE YEAR. AT THE END OF THIS PROJECT, WE WILL HAVE COLLECTED THE PRIMARY DATA REQUIRED TO COMMERCIALIZE OUR SOFTWARE TO POTENTIAL CUSTOMERS INCLUDING (1) A DESCRIPTION OF THE CUSTOMER RESOURCE REQUIREMENTS TO USE THE SOFTWARE ACROSS CPGS IN A HEALTH SYSTEM AND (2) IMPLEMENTATION OUTCOMES DEMONSTRATING THAT USERS USE THE SOFTWARE FREQUENTLY AS INTENDED AND GAIN MEANINGFUL INSIGHTS. THESE DATA WILL DEMONSTRATE VALUE FOR FUTURE CUST OMERS AND INVESTORS, ALLOWING US ACCELERATE THE TRANSLATION OF KNOWLEDGE INTO BETTER HEALTH OUTCOMES.