We propose to develop and evaluate an integrated patient-centered health information system, the Personal Health Partner (PHP). The PHP will use fully automated, interactive, conversations to gather personal health data and counsel parents before scheduled visits, exchange that data with the child’s primary care clinician via the electronic health record (EHR), and offer personalized follow-up assessment and counseling after visits.

This study will implement and evaluate electronic risk alerts to risk stratify outpatients with chest pain and present this information to primary care clinicians within the context of an electronic health record.

Thirty-three states and 1 territory formed the HISPC, which aims to address the privacy and security challenges presented by electronic health information exchange through multi-state collaboration. With the support of its state or territorial governor, each team engaged a steering committee and a range of local stakeholders to 1) assess variations in organization-level business policies and state laws that affect health information exchange; 2) identify and propose practical solutions, while preserving the privacy and security requirements in applicable Federal and State laws and 3) develop detailed plans to implement solutions.

Our proposed research will evaluate the full spectrum of e-prescribing in community-based ambulatory settings. We will begin by evaluating how physicians use e-prescribing in outpatient practice, then will bring together experts on information technology and health services researchers for a qualitative evaluation of the effects e-prescribing on prescribing processes and outpatient workflow. Finally, we will link e-prescriptions to patient claims data and will use this comprehensive dataset to evaluate the true clinical impact of e-prescribing.

Brigham and Women's Hospital, Boston, MA, in conjunction with physician practices in Massachusetts associated with a hospital network, will use an existing community utility for e-prescribing called the eRx Gateway. The pilot will test the e-prescribing standards and will conduct needed research into ambulatory drug safety and the impact of e-prescribing on physician workflows.

Medication errors occur frequently among patients in the ambulatory setting and cause many preventable adverse drug events; thus, they constitute an important target for patient safety and quality improvement. We propose a community-based randomized controlled trial of clinical-decision support to improve laboratory monitoring of medication use and a results management program to improve the timely follow-up of abnormal laboratory tests. This practical clinical trial will evaluate the effectiveness of promoting clinicians’ use of commercially available healthcare information technology to improve medication safety in the ambulatory care setting.

The Massachusetts Department of Public Health (MDPH) proposes to demonstrate the safety, security, quality and effectiveness of electronic transmission of prescriptions for federally controlled medications in the ambulatory care setting.  This project will encourage the adoption and diffusion of electronic prescribing, a key component of health IT and electronic health records, to improve medication management by ambulatory care clinicians at the point-of-care.

Ambulatory Care Compact to Organize Risk and Decisionmaking (ACCORD) will design, develop, implement, and evaluate an innovative model of care delivery that enables patients and primary care providers (PCPs) to agree upon shared, follow-up care plans that incorporate patient and provider preferences.

This project will create a Virtual Patient Advocate, a computerized animated character that emulates the face-to-face conversational behavior of an empathic provider and interacts with patients during the transition from the hospital to the ambulatory setting to improve the delivery, monitoring, and updating of patient-centered information to ensure patients have the information they need to make health care decisions.