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Ambulatory Safety and Quality Program: Health IT Portfolio

Enabling Patient-Centered Care Through Health IT

The purpose of this FOA is to investigate novel methods or evaluate existing strategies for using health IT to create or enhance patient-centered models of care in the ambulatory setting. Applicants were expected to demonstrate how patient-centered care can improve health outcomes, patient safety, and patients' reported experience with care. Applicants were encouraged to consider projects that focus on:

Shared decisionmaking.
Patient-clinician communication.
Personal health records.
Integration of patient information across transitions in care, or
Patient self-management of chronic conditions.

The long-term goal of this effort is to improve the delivery of patient-centered care in ambulatory settings.

Sixteen grants were awarded under this FOA. The projects have a diverse range of interventions, using different health IT applications. Most applications target the primary care office as the setting of care while others address the home environment. Two projects address subspecialty care and one specifically focuses on transitions between the inpatient and ambulatory setting. While all areas of patient-centered care are addressed across the grants, most of the projects focus on patient self-management.

Conversational IT for Better, Safer Pediatric Primary Care
Description: Develops and evaluates an integrated patient-centered health information system, the Personal Health Partner (PHP) that will use fully automated, interactive, conversations to gather personal health data and counsel parents before scheduled visits, exchange that data with the child's primary care clinician via the electronic health record (EHR), and offer personalized follow-up assessment and counseling after visits.
Estimated Total Funding: $1,159,609
Focus Area(s): patient self-management; access to medical information (clinicians)
Type of Health IT: Telehealth (patient-focused), PHR, Human/machine interface
Principal Investigator: William G. Adams
Grant No.: 1R18HS017248
Applicant Institution: Boston Medical Center, Boston, MA
Estimated Dates: 9/30/2007-9/29/2010

Using a Telemedicine System To Promote Patient Care Among Underserved Individuals
Description: Seeks to advance care for hypertension for African-Americans in North Philadelphia by enhancing an existing telemedicine system that supports the chronic care model by increasing access, incorporating hypertension treatment guidelines, quality measures, automating reminders and feedback for both patients and health care providers, and enabling the personal health record (PHR) to exchange data between other Health Level Seven (HL7)-compliant electronic medical record systems.
Estimated Total Funding: $1,198,371
Focus Area(s): patient self-management of chronic illness; access to medical information (patients and clinicians); shared decisionmaking; patient-clinician communication;
Type of Health IT: Telehealth (patient-focused), data electronic transform & load, clinical/medication reminders (patient & provider-focused)
Principal Investigator: Alfred Bove
Grant No.: 1R18HS017202
Applicant Institution: Temple University, Philadelphia, PA
Estimated Dates: 9/30/2007-9/29/2010

Enhancing Self-Management of T2DM With an Automated Reminder and Feedback System
Description: Tests an Automated Self-Management Monitor (ASMM) with low-income housing sites and through primary care clinics to determine whether ASMM can improve self-monitoring of blood glucose (SMBG) and glycemic control in patients with type II diabetes mellitus.
Estimated Total Funding: $1,166,243
Focus Area(s): patient self-management of chronic illness
Type of Health IT: clinical/med reminders (patient-focused), human/machine interface
Principal Investigator: Edith Burns
Grant No.: R18HS017276
Applicant Institution: Medical College of Wisconsin, Milwaukee, WI
Estimated Dates: 9/01/2007-8/31/2010

Personal Health Records and Elder Medication Use Quality
Description: Investigates the effect of a current PHR system among older adults on patient-reported medication therapy management (MTM) behaviors, beliefs about medications, medication-use quality indicators, and on medication adherence.
Estimated Total Funding: $1,199,999
Focus Area(s): patient self-management; access to medical information (patients)
Type of Health IT: human/machine interface, PHR, clincal/med reminders (patient-focused)
Principal Investigator: Elizabeth Chrischilles
Grant No.: 1R18HS017034
Applicant Institution: University of Iowa, Iowa City, IA
Estimated Dates: 9/30/2007-9/29/2010

Ambulatory Care Compact To Organize Risk and Decisionmaking (ACCORD)
Description: Designs, develops, implements, and evaluates a model of care delivery that enables patients and primary care providers (PCPs) to agree upon shared, followup care plans that incorporate patient and provider preferences.
Estimated Total Funding: $923,783
Focus Area(s): patient self-management; shared decisionmaking
Type of Health IT: System architecture, PHR
Principal Investigator: Henry Chueh
Grant No.: 1R18HS017190
Applicant Institution: Massachusetts General Hospital (MGH), Boston, MA
Estimated Dates: 9/30/2007-9/29/2010

Implementing a Low-Literacy, Multimedia IT System To Enhance Patient-Centered Cancer Care
Description: Tests whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhances patient-centered care and improves patient outcomes for vulnerable populations.
Estimated Total Funding: $1,198,839
Focus Area(s): Patient self-management of chronic illness; patient-clinician communication
Type of Health IT: Human/machine interface, clinical/medication reminders (patient-focused)
Principal Investigator: Elizabeth Hahn
Grant No.: 1R18HS017300
Applicant Institution: Evanston Northwestern Healthcare, Chicago, IL
Estimated Dates: 9/30/2007-9/29/2010

Virtual Patient Advocate To Reduce Ambulatory Adverse Drug Events
Description: Focuses on the transition between hospitalization and the first ambulatory visit; also tests a Virtual Patient Advocate (or VPA) to prepare patients for discharge and determines their degree of understanding of self-care, medications, and followup.
Estimated Total Funding: $1,180,772
Focus Area(s): patient self-management; access to medical information (patients and clinicians)
Type of Health IT: clinical/medication reminders (patient-focused), human/machine interface
Principal Investigator: Brian Jack
Grant No.: 1R18HS017196
Applicant Institution: Boston Medical Center, Boston, MA
Estimated Dates: 9/01/2007-8/31/2010

An Interactive Preventive Health Record (IPHR) To Promote Patient-Centered Care
Description: Investigates whether an interactive preventive health record (IPHR), called My Preventive Care, increases the delivery of recommended preventive services and whether the IPHR increases shared decisionmaking and improves clinician-patient communication.
Estimated Total Funding: $1,198,677
Focus Area(s): shared decisionmaking; patient-clinician communication
Type of Health IT: PHR, clinical/medication reminders (patient and provider focused)
Principal Investigator: Alexander Krist
Grant No.: 1R18HS017046
Applicant Institution: Virginia Commonwealth University, Richmond, VA
Estimated Dates: 9/01/2007-8/31/2010

Tailored DVD To Improve Medication Management for Low Literate Elderly Patients
Description: Uses an electronic medication history to develop tailored patient education DVDs and print materials for low-literate audiences to empower geriatric patients and their caregivers to participate in treatment decisions and negotiate acceptable medication regimens that are more amenable to follow-through.
Estimated Total Funding: $1,199,014
Focus Area(s): patient self-management; shared decisionmaking; patient-clinician communication
Type of Health IT: clinical/med reminders (patient-focused), human/machine interface
Principal Investigator: Kate Lapane
Grant No.: 1R18HS017281
Applicant Institution: Brown University, Providence, RI
Estimated Dates: 9/30/2007-9/29/2010

Using IT for Patient-Centered Communication and Decisionmaking About Medications
Description: Develops and tests a multimedia program to help patients understand the importance of both giving and receiving accurate information about medications.
Estimated Total Funding: $1,199,997
Focus Area(s): patient self-management; shared decisionmaking; patient-clinician communication
Type of Health IT: Clinical decision support, medication management (patient focused)
Principal Investigator: Gregory Makoul
Grant No.: 1R18HS017220
Applicant Institution: Northwestern University, Chicago, IL
Estimated Dates: 9/30/2007-9/29/2010

Impact of a Wellness Portal on the Delivery of Patient-Centered Prospective Care
Description: Develops, tests, and refines an Internet-based patient wellness portal linked to the previously developed Preventive Services Reminder System (PSRS) to facilitate preventive care in primary care practices.
Estimated Total Funding: $902,411
Focus Area(s): patient self-management; shared decisionmaking
Type of Health IT: Telehealth (patient-focused)
Principal Investigator: James Mold
Grant No.: 1R18HS017188
Applicant Institution: University of Oklahoma Health Sciences Center, Oklahoma City, OK
Estimated Dates: 9/01/2007-8/31/2010

Patient-Centered Informatics System To Enhance Health Care in Rural Communities
Description: Evaluates whether integrating the functions of an electronic medical record, personal health record, and communication system leads to more patient-centered care in rural communities in the Intermountain West.
Estimated Total Funding: $1,199,999
Focus Area(s): patient self-management; access to medical information (patients and clinicians); patient-clinician communication
Type of Health IT: Community Health Network (rural), clinical/medication reminders (provider and patient-focused)
Principal Investigator: Matthew Samore
Grant No.: 1R18HS017308
Applicant Institution: University of Utah, Salt Lake City, UT
Estimated Dates: 9/30/2007-9/29/2010

Harnessing Health IT for Self-Management Support and Medication Activation in a Medicaid Health Plan
Description: Tests the impact of the automated telephone self-management support (ATSM) on diabetes management and combine it with a medication activation communication strategy.
Estimated Total Funding: $1,130,769
Focus Area(s): patient self-management of chronic illness
Type of Health IT: Telehealth (patient-focused), human/machine interface, clinical/medication reminders (patient-focused)
Principal Investigator: Dean Schillinger
Grant No.: 1R18HS017261
Applicant Institution: University of California, San Francisco, San Francisco CA
Estimated Dates: 9/01/2007-8/31/2010

Using An Electronic Personal Health Record To Empower Patients With Hypertension
Description: Examines the feasibility, acceptability, and impact of a health IT intervention (the ePHR) that has been modified to incorporate the experiences, perspectives, and insights of patients and family members actually using the system.
Estimated Total Funding: $1,181,369
Focus Area(s): patient self-management of chronic illness; access to medical information (patients); patient-clinician communication
Type of Health IT: PHR
Principal Investigator: Patricia Sodomka
Grant No.: 1R18HS017234-01
Applicant Institution: Medical College of Georgia, Augusta, GA
Estimated Dates: 9/01/2007-8/31/2010

Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention
Description: Examines the effect of a Web-based intervention designed for patients with obstructive sleep apnea syndrome (OSA) that integrates a telemetry treatment device and an internet-based portal that tracks management of continuous positive airway pressure (CPAP).
Estimated Total Funding: $1,155,062
Focus Area(s): patient self-management of chronic illness
Type of Health IT: Telehealth (patient-focused), PHR
Principal Investigator: Carl Stepnowsky
Grant No.: 1R18HS017246
Applicant Institution: Veterans Medical Research Foundation, San Diego, CA
Estimated Dates: 9/30/2007-9/29/2010

Patient-Centered Online Disease Management Using a Personal Health Record System
Description: Evaluates Customized, Continuous Care Management (CCCM) program for diabetes care and examines the CCCM's impact on HgA1C as well as self-management practices, better processes of care, lower cardiovascular risk, enhanced patient experience and satisfaction, and improved patient psychosocial well-being.
Estimated Total Funding: $1,158,401
Focus Area(s): patient self-management of chronic illness; access to medical information (patients and clinicians)
Type of Health IT: PHR, clinical/medication reminders (patient-focused)
Principal Investigator: Paul Tang
Grant No.: 1R18HS017179
Applicant Institution: Palo Alto Medical Foundation Research Institute, Palo Alto, CA
Estimated Dates: 9/01/2007-8/31/2010

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More Information

For additional information on AHRQ projects on health information technology, go to: http://www.healthit.ahrq.gov or contact the health IT staff at healthit@ahrq.hhs.gov.

Current as of September 2007

Internet Citation:

Ambulatory Safety and Quality Program: Health IT Portfolio. Program Brief. September 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/ambsafety/ambsafety.htm