Conversational IT for Better, Safer Pediatric Primary Care

Boston Medical Center, Boston MA

Investigators

Linked publications & trials

Abstract

A large gap exists between what is recommended for effective primary care of children and what actually takes[unreadable] place in pediatric primary care settings, especially in the areas of preventive care. Furthermore, although medication[unreadable] management (safety and effectiveness) issues have emerged as an important factor for children, little is known about[unreadable] how medication is actually used by families at home. Interactive telephony technologies offer a potentially highly[unreadable] effective, patient-centered communication modality by guiding parents at home through interactive discussions that[unreadable] can gather information and actively reinforce recommendations and treatments. Interactive telephony systems are[unreadable] particularly well suited for use in vulnerable populations since access to the telephone is nearly universal, and the[unreadable] system does not rely on reading printed text. We propose to develop and evaluate an integrated patient-centered[unreadable] health information system, the Personal Health Partner (PHP). The PHP will use fully automated, interactive,[unreadable] conversations to gather personal health data and counsel parents before scheduled visits, exchange that data with the[unreadable] child?s primary care clinician via the electronic health record (EHR), and offer personalized follow-up assessment and[unreadable] counseling after visits.[unreadable] The Personal Health Partner System will be evaluated in a randomized clinical trial to determine whether when[unreadable] compared to usual care: 1) PHP preventive and medication management assessments (without counseling) combined[unreadable] with EHR data exchange lead to higher quality preventive care and medication management; and 2) PHP with[unreadable] automated counseling is also associated with increased parental activation and healthier parental behaviors.[unreadable] We will also explore whether: 1) use of the PHP system will be feasible for parents and clinicians; 2) parents with[unreadable] low health literacy are able to use the PHP system as effectively as those with higher health literacy; 3) parents who[unreadable] receive PHP assessments with counseling are more likely to be counseled or change their behavior than those who[unreadable] receive PHP assessment only; and 4) the PHP system can automatically detect medications errors following new[unreadable] prescriptions in primary care settings.[unreadable] The IT-based approach to be evaluated in this project will link parents and children outside the clinical setting with[unreadable] their primary care center and will offer comprehensive assessments AND counseling to reinforce and support parental[unreadable] behavior change. With growing use of the EHR come new opportunities to link patient-centered information with[unreadable] clinical health information systems. Linkage of these systems has the potential to inform and activate parents, provide[unreadable] much richer data to drive decision support at the point-of-care, and to provide ongoing support for long-term behavior[unreadable] change following primary care visits. The use of conversational technologies as the foundation for the project offers a[unreadable] number of unique advantages especially the support of lower-literacy populations and near-universal access.[unreadable] Systems like the PHP represent a model for the future of ambulatory care and the sustainable, affordable delivery of[unreadable] higher quality and safer care by primary care clinicians in the future.