A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial

“Our randomized controlled trial (RCT) found a physician-focused decision support tool to be effective in increasing CVD risk assessment when embedded within the primary care clinical record system. In particular, personalized risk score information that is explained on a visually interesting interface, can make the impact of improving biometric risk factor values (for example, blood pressure), or behaviors (for example, smoking cessation), more compelling. Hypothesized as a useful springboard to more engagement by patients with CVD risk factor control, the concept was adapted to a consumer-facing resource in the current trial. Other trials have demonstrated the benefits of apps for … Read More

Scaling Up Provider-Payer Workflows

Published 2020.9.30 I am involved in several health information technology (health IT) interoperability efforts including the Da Vinci project (a private sector initiative that addresses the needs of the Value Based Care community by leveraging the HL7 [a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services] FHIR platform), Office of the National Coordinator for Health IT Fast Healthcare Interoperability Resources (FHIR) at Scale Taskforce (ONC FAST, a group of “motivated … Read More

Effects of Counseling by Peer Human Advisors vs Computers to Increase Walking in Underserved Populations: The COMPASS Randomized Clinical Trial

“Technology-enabled eHealth programs represent potentially cost-efficient and practical means for customized PA [physical activity] guidance to diverse groups. Most people targeted by eHealth, however, are well educated, younger than 50 years, and of non-Hispanic White ancestry, potentially intensifying health disparities. [..] This investigation tested whether a virtual advisor could increase 12-month walking to an extent similar to a comparably structured human advisor program among Latino adults. The human advisor program was delivered by trained peer advisors—a resource-efficient approach that is well accepted by Latino and other diverse groups but may be less convenient and scalable than computer-based programs. [..] Both … Read More

Remote symptom monitoring integrated into electronic health records: A systematic review

“This systematic review identified and summarized EHR-integrated systems to remotely collect patient-reported symptoms and examined their anticipated and realized benefits in long-term conditions. [Results] We included 12 studies representing 10 systems. Seven were in oncology. Systems were technically and functionally heterogeneous, with the majority being fully integrated (data viewable in the EHR). Half of the systems enabled regular symptom tracking between visits. We identified 3 symptom report-guided clinical workflows: Consultation-only (data used during consultation, n = 5), alert-based (real-time alerts for providers, n = 4) and patient-initiated visits (n = 1). Few author-described anticipated benefits, primarily to improve communication and resultant health outcomes, were realized based … Read More