Improving Quality of Care and Patient Outcomes During Care Transitions (R01)

Implementing Personalized Cross-Sector Transitional Care Management to Promote Care Continuity, Reduce Low-Value Utilization, and Reduce the Burden of Treatment for High-Need, High-Cost Patients

Description

This research will integrate cross-sector care alerts and interoperable personalized care planning into the existing Coordinating Transitions Intervention (CTI) tool and evaluate the impact of the revised tool on patient burden, care team collaboration, and utilization value for high-need, high-cost patients.

Grant Number
R01 HS028000
Principal Investigator(s)

EnhanCed HandOffs (ECHO)

Description

This research will develop and evaluate a machine learning-augmented and telemedicine-augmented sociotechnical intervention for postoperative handoffs to reduce the risks of patient complications and improve patient-centered care.

Grant Number
R01 HS029324
Principal Investigator(s)