Research and Projects: AHRQ THQIT and SRD Portfolio

Oklahoma

INTEGRIS Telewoundcare Network

Description:  Demonstrates and evaluates the clinical effectiveness and cost-savings of utilizing telehealth technology to reduce the days to healing for chronic wounds by improving access to caregivers, point of care processes, and dissemination of best practice information.

Abstract:  DESCRIPTION (provided by the applicant): This study is designed to demonstrate the clinical effectiveness and cost-effectiveness of utilizing telehealth technology to reduce the days to heal for chronic wounds. This will be accomplished through the utilization of health information technology to improve access to knowledgeable caregivers, point of care processes, and dissemination of best practice information. The study approaches wound care as a continuum of care addressing underlying etiology (diabetes) as well as the immediate wound treatment regimen. The study will be a controlled trial to evaluate a telehealth strategy, which incorporates evidence-based guidelines, by comparison to the current standard care provided in the community. The primary outcome measure will be the time to healing of the wound. The unit for allocation will be the different counties in Oklahoma, but the unit of analysis will be the individual patient. This strategy is used to avoid contamination of the standard care control group by the telehealth/evidence-based strategy, which would occur if the same providers in a county were delivering care in both the control and intervention groups. A true randomized allocation to the intervention or control groups is not possible due to logistic reasons, and to avoid withdrawal of telehealth services from counties in which this has already been implemented. We will minimize bias in allocation by using matching counties by their demographic and other characteristics, and then allocating counties within these pains to receive either the experimental telehealth intervention or the community standard care (control group). Bias in the assessment of the outcome of wound healing will be avoided by taking pictures of the wound, using a standardized method, at fixed intervals in all patients, and having these pictures interpreted by an independent clinical expert, without knowledge of the patient's group assignment, clinical features or other information. The study will incorporate a combination of broadband, analog, and web-based applications to serve patients in a variety of settings including clinics, homes and long-term care facilities.

Year 1 Funding:  $354,000

Estimated Total Funding:  $1,063,213

Principal Investigator:  Charles Bryant

Applicant Institution:  INTEGRIS Health, Inc.

City/Town:  Oklahoma City, Oklahoma

State:  Oklahoma

Grant Number:  UC1 HS15359

Category:  Implementation Grants (THQIT)

Thesaurus Terms:  automated health care system, automated medical record system, chronic disease /disorder, disease /disorder prevention /control, disease /therapy duration, human therapy evaluation, patient care management, telemedicine, wound, wound healing, clinical trial, computer system design /evaluation, cooperative study, cost effectiveness, diabetes mellitus, health care personnel education, health care quality, health care service availability, health care service utilization, health education, rural health, clinical research, human subject, outcomes research, patient oriented research

Project Start Date:  Sep 30, 2004

Project End Date:  Sep 29, 2007