Personalized learning intervention to enhance hypertension care skills of physicians and extended-care providers [abstract] Abstract uri icon
  • Hypertension (HT) control is suboptimal in diabetes (DM) patients in part because of the complexity of the underlying physiology and the many cognitive processes and tasks that are required of providers to promote optimal management.
    Opinion leader interventions demonstrate that personalized learning interventions can hone provider cognitive processes and improve care. However, these interventions are expensive and difficult to standardize. We've developed a patient-based simulation model (SimCare) designed to (a) reproduce complex patient situations, (b) capture provider thinking and decision making activity, and (c) provide personalized feedback to improve HT-related cognitive processes and HT care skills of providers.
    SimCare uses a JEE software application hosted on a Weblogic cluster running on Linux with an Oracle database backend running on AIX. The model incorporates a set of “patient state predictors” developed by expert physicians; these are stacked in a predefined way and are configurable in a plug and play fashion.
    An electronic medical record (EMR-like) interface presents complex medical scenarios and enables the user to perform multiple clinical functions like (1) review chart history and medications (2) order labs, medications, and diagnostic tests (3) make referrals and provide patient instructions, and (4) schedule follow up at any desired interval. The model simulates relevant “patient states” including vital signs (BP, BMI), labs (A1c, lipids, creatinine, etc.), and behavioral factors (lifestyle, adherence). Formulas derived from published literature and clinical experience are used to compute cumulative and incremental physiologic effects of different clinical decisions over time The user receives feedback after each encounter related to actions taken or overlooked. The open source rules engine (Drools) can be maintained independently from the application to facilitate incorporation of new treatments or care recommendations.
    This web-based teaching application is suitable for use by diabetes educators or nurses who wish to enhance cognitive processes clinical care ability related to blood pressure control in adults with diabetes.

  • publication date
  • 2010
  • published in
  • Diabetes  Journal
  • Research
  • Comorbidity
  • Diabetes
  • Education, Medical
  • Hypertension
  • Internet
  • Models
  • Simulation
  • Additional Document Info
  • 59
  • issue
  • Suppl 1