The Institute of Medicine's Crossing the Quality Chasm suggests that, without intervention, it takes, on average, 17 years to disseminate new knowledge generated by randomized trials into practice. Evidence-based computerized reminders have proven to be effective at improving the quality of care for cancer preventive services, yet such systems have rarely been tested for improving the quality of care for patients with chronic conditions such as osteoarthritis.
The aim of this Phase 1 SBIR is to develop and test and formatively test a working prototype of an interactive website with the following major functions, based on consensus guidelines for osteoarthritis care from the American College of Rheumatology Subcommittee on Osteoarthritis Guidelines: 1) to proactively query patients, before each visit with a health care provider, to understand what osteoarthritis care the consensus guidelines suggest they are due, 2) to provide brief, tailored, onscreen feedback to patients regarding the osteoarthrits care they are due, 3) to provide brief, tailored, faxed reminders to health care providers, timed to coincide with the patients' visit, regarding the osteoarthritis care they are due. This expands on the current work of Green Lights, Inc. in developing a single website, www.myexpertdoctor.com, where patients would have access to computer tailored, guideline-based recommendations, for the management of the most common health conditions in the US. We believe this approach has significant potential for disseminating evidence-based consensus guidelines for osteoarthrits and therefore have a significant and positive impact on osteoarthritis-related disability in the United States. The prototype interactive website has the potential to be marketed to the following three parties: 1) patients will want to use the system to learn what to expect and what questions to ask during their doctor visits, 2) health care providers will want to use the system to streamline their care of chronic conditions such as osteoarthritis and be sure that it is evidence-based and 3) managed care organizations will be interested in the potential of the system as a quality improvement initiative possibly to satisfy requirements from the National Committee for Quality Assurance, [Assurance, 1998 #249]. Given the steady increase in Internet access, we believe that myexpertdoctor.com, and similar offerings that it will inspire, will have a significant and positive impact on osteoarthritis-related disability in the United States.
