(provided by the applicant): This four-year project seeks to equip a clinician-scientist with a significant expertise in knowledge management (KM) and clinical decision support (CDS) with training and mentoring in health services research. This proposal aims at preparing the applicant to pursue a career as an independent investigator developing and evaluating KM and CDS interventions aimed at improving the quality, safety, efficiency, and effectiveness of health care in the U.S. and abroad. The candidate is an Assistant Professor of clinical informatics at Duke University with an M.D. degree and a Ph.D. in biomedical informatics. The candidate is the architect of a corporate-wide clinical knowledge delivery infrastructure and the author of an international knowledge delivery standard. The candidate will be mentored by a group of established investigators headed by Dr. Eric Peterson, the Director of Cardiovascular Research at the Duke Clinical Research Institute. The training and research will leverage unique scientific and training resources available at Duke University. As the primary component of his career development activities, the candidate will pursue a mentored research project focused on the development, implementation, and evaluation of a prototype for a scalable and replicable knowledge delivery system. The candidate will also pursue formal training, particularly in health services research;develop expertise in health IT standards relevant to KM and CDS;and prepare manuscripts and grant applications. The goal of the proposed research is to develop, implement, and evaluate a prototype for a scalable and widely deployable knowledge delivery service ("knowledge broker") capable of automatically delivering context-specific knowledge from online resources into electronic health record (EHR) and personal health record (PHR) systems via a "knowledge dashboard." The research will be conducted in accordance with three specific aims: (i) to build a knowledge base of patients'and providers'knowledge needs;(ii) to design, develop, and evaluate the usability of a scalable, widely deployable knowledge delivery service in a laboratory setting;(iii) To conduct a mixed-method assessment of a pilot implementation of the knowledge broker in a real-world Medical Home environment. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. In addition, the proposed software component is aligned with the development of an international standard within HL7 to support the integration between knowledge resources into EHR and PHR systems. Thus, if successful, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. This project seeks to support health care decision making and patient-centered care by delivering relevant, context-specific knowledge to patients and providers. The proposed system will be developed in conjunction with an emerging international standard on the integration between online knowledge resources and electronic health records. Thus, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale and play a significant role in the overall improvement of public health.

Public Health Relevance

The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. This project seeks to support health care decision making and patient-centered care by delivering relevant, context-specific knowledge to patients and providers. The proposed system will be developed in conjunction with an emerging international standard on the integration between online knowledge resources and electronic health records. Thus, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale and play a significant role in the overall improvement of public health.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01HS018352-05
Application #
8286769
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
Project Start
2009-09-30
Project End
2013-08-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
5
Fiscal Year
2012
Total Cost
Indirect Cost
Name
University of Utah
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
Del Fiol, Guilherme; Workman, T Elizabeth; Gorman, Paul N (2014) Clinical questions raised by clinicians at the point of care: a systematic review. JAMA Intern Med 174:710-8
Del Fiol, Guilherme; Curtis, Clayton; Cimino, James J et al. (2013) Disseminating context-specific access to online knowledge resources within electronic health record systems. Stud Health Technol Inform 192:672-6
Zhang, Mingyuan; Del Fiol, Guilherme; Grout, Randall W et al. (2013) Automatic identification of comparative effectiveness research from medline citations to support clinicians' treatment information needs. Stud Health Technol Inform 192:846-50
Jonnalagadda, Siddhartha Reddy; Del Fiol, Guilherme; Medlin, Richard et al. (2013) Automatically extracting sentences from Medline citations to support clinicians' information needs. J Am Med Inform Assoc 20:995-1000
Strasberg, Howard R; Del Fiol, Guilherme; Cimino, James J (2013) Terminology challenges implementing the HL7 context-aware knowledge retrieval ('Infobutton') standard. J Am Med Inform Assoc 20:218-23