VCU School of Medicine, RTI International to Explore How Observations From Daily Life Could Transform Chronic Care Management

By Sathya Achia Abraham

A research team from the Virginia Commonwealth University School of Medicine and RTI International has been selected as one of five nationwide to participate in a Robert Wood Johnson Foundation project to explore how patient-recorded observations of daily living can be captured, interpreted and integrated into clinical care.

The Robert Wood Johnson Foundation, or RWJF, through its Project HealthDesign: Rethinking the Power and Potential of Personal Health Records national program, announced grants to five teams that will test how the use of health information technology can help people become more informed patients and better consumers of health care.

The grantees will work with patients to explore how day-to-day information – such as stress levels of caregivers of premature infants and medication-taking routines of seniors at risk of cognitive decline – can be collected, interpreted and acted upon by patients as well as clinicians in real-world clinical settings. The VCU-RTI team has been awarded a $480,000 grant for the two-year project.

“This project will establish a new vision of how personal health records can and should be used to strengthen the communication between a patient and the provider,” said Patricia Flatley Brennan, R.N., Ph.D., national program director for Project HealthDesign. “Things that people notice every day such as what they eat, how physically active they are, whether they have pain or other symptoms, are not typically captured in visits to the doctor but they are key pieces of information in managing health.

“With the help of new technologies, we can now record this information and provide clinicians a more accurate and useful picture of a patient’s health and the best ways to care for them,” Brennan said.

The project builds on earlier Project HealthDesign work revealing that the data needed to inform day-to-day health decisions came less often from information contained in people’s official medical record and more from information gained by monitoring health in everyday life.

“We know patients want better relationships with their clinicians and to make the most of their time during a doctor’s visit. Through Project HealthDesign, the patients and the clinicians will be working together to collect and interpret insights from the patient’s everyday life. This process will help empower people to be more informed patients and allow clinicians to determine if their care plan is working,” said Stephen Downs, assistant vice president for RWJF’s Health Group.

The VCU-RTI team has been awarded its grant for a two-year project called BreathEasy, a personal health record for asthmatics. Through a pilot program, the team will evaluate a patient cell phone platform for usefulness and usability. The principle investigator for the project is Barbara L. Massoudi, Ph.D., a senior research health scientist who leads the health informatics program at RTI. Stephen Rothemich, M.D., co-director of the Ambulatory Care Outcomes Research Network in the VCU Department of Family Medicine, will be leading the efforts at VCU.

“As physicians, we see patients with asthma and we ask how they are doing, but we have little information about how they are really doing between office visits. This technology is one that empowers the patient and helps them get more involved with their health care by reporting between visits on their asthma symptoms, triggers and use of maintenance and rescue medications. This portable technology may help us stay more connected with our asthma patients and improve their care,” said Rothemich.

Along with the other four teams selected for the grants, the VCU-RTI team will first participate in a refine-and-design phase to share ideas, establish goals and refine initial approaches. Project teams will then work with patients with complex chronic conditions to capture and interpret observations of daily living, or ODLs – what they ate, how they slept, what their mood was, how their medications made them feel and other factors – while establishing a relationship with a physician practice to share information. Over the 12 months, clinicians will care for between 30 and 50 patients who are actively monitoring ODLs and assess the value of including the ODLs in their real-world care processes.

Since its launch in 2006, RWJF has committed a total of $9.5 million in grant funds and technical assistance to the program, led by a team of experts working in health information technology and patient-centered care at the University of Wisconsin-Madison. Project HealthDesign is supported by RWJF’s Pioneer Portfolio, which supports innovative ideas and projects that can lead to significant breakthroughs in the future of health and health care.