The Integrated Tracking, Referral, and Electronic Decision Support, and Care Coordination (I-TREC) program: scalable strategies for the management of hypertension and diabetes within the government healthcare system of India
| Autor: | Dorairaj Prabhakaran, Rakshit Sharma, Yashdeep Gupta, Mumtaj Ali, Hanspria Sharma, Priti Gupta, Shivani A. Patel, Devraj Jindal, K.M. Venkat Narayan, Mohammed K. Ali, Ambuj Roy, Prashant Jarhyan, Mary Beth Weber, Nikhil Tandon, Sailesh Mohan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Rural Population Decision support system Referral India Information technology 030204 cardiovascular system & hematology Clinical decision support system Health informatics Health administration 03 medical and health sciences Study Protocol 0302 clinical medicine Health facility Continuum of care Diabetes Mellitus Medicine Health system Electronic Health Records Humans 030212 general & internal medicine Quality improvement mHealth Referral and Consultation business.industry Health Policy Nursing research lcsh:Public aspects of medicine Diabetes lcsh:RA1-1270 medicine.disease Decision Support Systems Clinical Databases as Topic Research Design Hypertension Implementation science Medical emergency business Delivery of Health Care |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 20, Iss 1, Pp 1-12 (2020) |
| ISSN: | 1472-6963 |
| Popis: | Background Hypertension and diabetes are among the most common and deadly chronic conditions globally. In India, most adults with these conditions remain undiagnosed, untreated, or poorly treated and uncontrolled. Innovative and scalable approaches to deliver proven-effective strategies for medical and lifestyle management of these conditions are needed. Methods The overall goal of this implementation science study is to evaluate the Integrated Tracking, Referral, Electronic decision support, and Care coordination (I-TREC) program. I-TREC leverages information technology (IT) to manage hypertension and diabetes in adults aged ≥30 years across the hierarchy of Indian public healthcare facilities. The I-TREC program combines multiple evidence-based interventions: an electronic case record form (eCRF) to consolidate and track patient information and referrals across the publicly-funded healthcare system; an electronic clinical decision support system (CDSS) to assist clinicians to provide tailored guideline-based care to patients; a revised workflow to ensure coordinated care within and across facilities; and enhanced training for physicians and nurses regarding non-communicable disease (NCD) medical content and lifestyle management. The program will be implemented and evaluated in a predominantly rural district of Punjab, India. The evaluation will employ a quasi-experimental design with mixed methods data collection. Evaluation indicators assess changes in the continuum of care for hypertension and diabetes and are grounded in the Reach, Effectiveness, Adoption Implementation, and Maintenance (RE-AIM) framework. Data will be triangulated from multiple sources, including community surveys, health facility assessments, stakeholder interviews, and patient-level data from the I-TREC program’s electronic database. Discussion I-TREC consolidates previously proven strategies for improved management of hypertension and diabetes at single-levels of the healthcare system into a scalable model for coordinated care delivery across all levels of the healthcare system hierarchy. Findings have the potential to inform best practices to ultimately deliver quality public-sector hypertension and diabetes care across India. Trial registration The study is registered with Clinical Trials Registry of India (registration number CTRI/2020/01/022723). The study was registered prior to the launch of the intervention on 13 January 2020. The current version of protocol is version 2 dated 6 June 2018. |
| Databáze: | OpenAIRE |
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