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VA Integrated Medication Manager (IMM)

17. maj 2016 opdateret af: University of Utah

Veterans Affairs Integrated Medication Manager

The purpose of this study is to advance the science of healthcare informatics and to improve medication management through the development of a new approach to the electronic medical record called the Integrated Medication Manager (IMM).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In an attempt to address problems patient non-compliance with quality goals barriers to access and integration of health information that impede achievement of treatment goals, the VA is developing a new approach to the electronic medical record. The VA is moving away from the paper-chart metaphor and towards an integrated representation of the patient's status and care process across time. One of the first steps in the development phase has been to explicitly relate patient conditions, therapies, and goals in the domain of pharmacotherapy. This is called Integrated Medication Management and draws on Hollnagel's Contextual Control Model. Providers will be able to plan care and create orders directly in the context of these explicit relationships. This application will be implemented nationwide through a web interface embedded within the existing Computerized Patient Record System (CPRS), the graphical user interface to VA Information Systems (VistA).

Aim 1: Identify cognitive components of providers' therapeutic decision making in the field.

Aim 2. Refine and evaluate the Integrated Medication Manager using simulation studies.

  • Aim 2.a. Refine interfaces and logic of the Integrated Medication Manager.
  • Aim 2.b. Compare the performance of the Integrated Medication Manager and usual CPRS.

All hypotheses (below) test the use of IMM versus usual electronic medical record (EMR).

  • Speed of decision-making will be faster.
  • Accuracy of data interpretation (clinical assessment) will be higher.
  • Appropriateness of therapeutic plans will be higher.
  • Efficiency of gathering information will be higher.
  • Common ground measures will be higher.
  • Appropriateness of therapeutic plans will be higher when relevant data is outside the usual time horizon.
  • Appropriateness of therapeutic plans will be higher when complex associations among patient therapies and goals exist.
  • Appropriateness of therapeutic plans will be no lower when relevant data is not captured by the displays of the IMM.
  • Appropriateness of therapeutic plans will be higher when highly salient data is not germane to the most important problem.
  • Appropriateness of therapeutic plans will be higher when cognitive load is high due to interruptions.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

58

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84148
        • VA SLC Health Care System

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Practiced in primary care for at least two years
  • Third year residents with two years of residency in internal medicine or family practice
  • Do not have to be currently practicing

Exclusion Criteria:

  • None

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Integrated Medication Manager
Experienced providers that participated in the EHR simulations. Half of the providers were assigned to use the new Integrated Medication Manager (intervention) during the simulation. The other half were assigned the VA's CPRS to use (standard EHR). Providers were randomly assigned which system to use.
Andet: Integrated Medication Manager
A theory based electronic health record. Half of the provider participants were assigned the IMM to use. The other half were assigned the VA's CPRS EHR to use for the simulation. Providers were randomly assigned to a EHR to use.
Andre navne:
  • IMM
Ingen indgriben: Standard EHR
Experienced providers that participated in the EHR simulations. Half of the providers were assigned to use the new Integrated Medication Manager (intervention) during the simulation. The other half were assigned the VA's CPRS to use (standard EHR). Providers were randomly assigned which system to use.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Amount of Time to Complete Assessment and Plan
Tidsramme: 10 minutes
Each participant had 10 minutes maximum to review the patient case and write an Assessment and Plan.
10 minutes
Accuracy of Written Assessment and Plan in Terms of Control and Status
Tidsramme: 10 minutes
Each participant had 10 minutes maximum to review the patient case and write an Assessment and Plan. The primary outcome evaluated participants' recommendations for treatment of patient conditions. Participants reviewed a total of 10 patient cases and received a score between 0 and 3 points for each issue within each patient case. The final score for each participant was a proportion between 0 and 1. The proportion represented the sum of all points assigned to the participant, divided by the total number of points possible. Higher values on the scale represent greater accuracy of the written assessment and plan.
10 minutes

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Identification of Planned Monitoring and Follow up Encounters in Assessment and Plan
Tidsramme: 10 minutes
Each participant had 10 minutes maximum to review the patient case and write an Assessment and Plan. . The secondary outcome evaluated participants' recommendation about future monitoring of patient conditions. Participants reviewed a total of 10 patient cases and received a score of 0 or 1 point for each issue within each case. The final score for each participant was a proportion between 0 and 1. The proportion represented the sum of all points assigned to the participant, divided by the total number of points possible. Higher values on the scale represent a greater proportion of appropriate monitoring recommendations made.
10 minutes

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Utah

Samarbejdspartnere

Agency for Healthcare Research and Quality (AHRQ)

Efterforskere

  • Ledende efterforsker: Jonathan Nebeker, MD, MS, University of Utah

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. oktober 2007

Primær færdiggørelse (Faktiske)

1. marts 2011

Studieafslutning (Faktiske)

1. marts 2011

Datoer for studieregistrering

Først indsendt

22. januar 2013

Først indsendt, der opfyldte QC-kriterier

5. februar 2013

Først opslået (Skøn)

8. februar 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

23. juni 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. maj 2016

Sidst verificeret

1. maj 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • 5R18HS017186-03 (U.S.A. AHRQ bevilling/kontrakt)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Elektroniske sundhedsjournaler

Kliniske forsøg med Integrated Medication Manager

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner