Individuals with Chronic Care Needs

This research will test and validate a machine learning predictive analytic intervention to optimize the timely and appropriate use of interpreters for hospitalized patients with language barriers and complex care needs.

This research will refine an existing interoperable, patient-facing blood pressure control tool--the Collaboration Oriented Approach to Controlling High Blood Pressure (COACH) application--evaluate its implementation into three diverse clinical settings; conduct a randomized trial to assess its impact on lowering blood pressure; and develop a shareable, interoperable mechanism to aid in the dissemination of patient-facing clinical decision support tools.

This research will develop and test novel approaches for using electronic health record metadata to characterize and evaluate hospital discharge planning practices, with the long-term goal of providing tools to monitor and strengthen specific behaviors within discharge workflows that optimize post-acute transitions of care.