New
CRNII Project: HIT 2
Using Electronic Medical Records to
Measure and Improve Adherence to
Tobacco Treatment Guidelines in
Primary Care
A key element of this project is to use natural language processing to code tobacco use assessment and treatment as coded in the electronic medical record of four CRN health plans. This project presents some interesting challenges, not the least of which is to develop comparable data extraction procedures in four CRN health plans. The HIT 2 investigators started meeting in the fall of 2002 to develop these procedures and we are making good progress.
We are also applying natural language processing to develop a method for electronically coding tobacco use assessment and treatment as noted in the progress notes from primary care visits. Although there are clear, evidenced-based practice guidelines for tobacco cessation treatment in primary care, recording such treatment in the medical record is far from standardized. By the fall we will have a prototype parser for this task, and we will spend the winter testing and improving this parser in each of the four HIT health plans. We plan to start baseline data collection in the spring of 2004.
- Vic Stevens, KPNW
| CRN Connection
The CRN Connection is a quarterly publication of the CRN developed to inform and occasionally entertain CRN Collaborators. It is produced under the oversight of the CRN Communications Committee.
Contributors : Gary Ansell, Kari Bohlke,
Martin Brown, Donna Eubanks,
Sarah Greene, Chris Neslund-Dudas
Vic Stevens, and Ed Wagner
Oversight : Gary Ansell, Martin Brown
Cindy Cadoret, Sarah Greene, Chelsea Jenter
Gene Hart, Kimberly Hill, Judy Mouchawar
Dennis Tolsma, and Ed Wagner
Produced by:Kelly-Jane H. Denke, CHS Graphics
Please send comments or suggestions on this newsletter to Chelsea Jenter, CRN Project Director, at jenter.c@ghc.org. All submissions are welcome!
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CRN Affiliated Projects
In addition to the core projects from CRNI (DETECT, PROTECTS and HIT) and CRNII (DCIS, MENU, and HIT2), the CRN has many affiliated projects. Below is a table of all of the funded affiliated projects to date. The CRN Connection has featured articles about some of these projects in past issues of the CRN Connection (all available for viewing on the CRN website). The CRN Connection will continue to feature progress from these projects in future issues.
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Project Title
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Acronym
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Funding Source
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Last seen in
CRN Connection.
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Design, Implementation and Analysis of a Clinician
Survey
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NCI Supplement
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Pilot Study to Identify Organizational Barriers
to HMO Participation in Clinical Trials
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Barriers Study
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NCI Supplement
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Jan 2001
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Evaluation of End-of-Life Care for Prostate Cancer
in the Managed Care Environment
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Prostate EOL
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CDC Task Order
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Sep 2003
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Enrolling Vietnamese and Chinese Women in Breast
Cancer Treatment and Prevention Trials
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Enrolling Asian Women
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NCI Supplement
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| Patient-Oriented Outcomes of Prophylactic Mastectomy |
PM Outcomes |
NCI R01 Grant |
Aug 2000 |
| Colon Cancer Survivors - Medications and Risk
of Recurrence |
CARE |
NCI R01 Grant |
Jun 2001 |
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Cancer Surveillance in HMO Administrative Data
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IMPACT
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NCI R01 Grant
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Jun 2001
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The Impact of Endocrine Therapy on Survival in
Men with Local or Regional Prostate Cancer-Feasibility Study
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PETS
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NCI Supplement
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Nov 2001
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| A Pilot Study of Disenrollment among HMO Patients
with Cancer |
Disenrollment |
NCI Supplement |
Sep 2002 |
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Lung/Colon Cancer Outcomes: The Cancer Research
Network
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CanCORS
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NCI Cooperative Agreement
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Sep 2002
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Breast Cancer Treatment Effectiveness in Older
Women
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BOW
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NCI R01 Grant
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Evaluation of Hospice Referral and Palliative
Care for Ovarian Cancer in the Managed Care Environment
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Ovarian EOL
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CDC Task Order
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HRT Initiation and Cessation Following Results
From the Women's Health Initiative
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HRT Diffusion
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NCI Supplement
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Medication Use and Risk of Esophageal Adenocarcinoma
and Barrett's Esophagus
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Esophageal Adeno
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NCI Contract
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Michigan Center for Health Communications Research
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CHCR EC
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NCI P50 Grant
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Sep 2003
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Information about cancer prevention is routinely conveyed to our health plan members through the medical profession, mass media, and other sources. But information is not enough to change health behaviors, nor prevent cancer. Research by University of Michigan professor Vic Strecher (and many others in the field) has demonstrated that tailoring health information to individual circumstances (motivational style, home environment, gender, etc.) is far more effective than generic health information. Yet the question of why tailoring works is not fully understood. The newly-funded Center for Health Communications Research (CHCR) hopes to open what Strecher calls "the black box" of tailoring to determine which components are most influential on health behavior change.
The Center is comprised of three research projects, and five cores that support the work of these projects. The projects are all randomized trials that will be conducted in two phases. Phase I uses an experimental design in which numerous tailoring variables are tested to see what has the strongest effect; in Phase II, the most promising elements will be tested to identify the optimal "dose," mode of delivery, and combination of effects.
Henry Ford Health System, Kaiser Permanente Georgia, and Group Health Cooperative are collaborating with the University of Michigan on this Center grant. The Recruitment and Data Collection Core will be based at GHC. It is charged with recruiting all subjects for the three studies, and collecting baseline and follow-up data via telephone surveys.
Each project addresses a different aspect of cancer
prevention: (1) smoking cessation; (2) fruit and
Communication Center vegetable consumption; and (3) decisions about
prophylactic use of tamoxifen to prevent breast cancer. As mentioned above, the five cores will together provide a supportive infrastructure for the three projects: Administration Core; Biostatistics Core; Theory and Measurement Core; Tailoring Technology Core; and Recruitment and Data Collection Core.
The CHCR is an exciting and innovative undertaking, and will definitely move the field of cancer communication science in new directions. Three other Centers were funded by NCI as part of this initiative. Each Center will receive $10 million over five years. Future issues of the CRN Connection will include profiles of the individual projects in the CHCR.
- Sarah Greene, CHS
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