DIGI Grant Winners
The DIGI Grant provides awards to UMass Memorial Medical Group providers to support novel approaches to the use of digital health technologies that have a positive impact on quality, efficiency, patient and/or provider engagement, health equity, or financial outcomes.
The goal of this grant award is to support our health care providers and foster innovation in digital health across UMass Memorial Health and is intended to cover the time spent by faculty/staff to implement the proposed project with a maximum award of $40,000 over 12 months.
Each of the 2024 DIGI Grant award recipients listed below received $35,000. Recipients include:
Embedding Early Relational Health Screening Measures Into Clinical Workflow Utilizing a Digital Health Strategy
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Early Relational Health (ERH) describes the state of emotional well-being between an infant or young child and their parents or primary caregivers. ERH represents the presence of safe, stable, and nurturing relationships (SSNRs) in an infant’s early environment, that positively shape a child’s growth and development. A critical component in supporting ERH is promoting early opportunities for face-to-face bonding and social-emotional engagement between mother and infant. However, NICU hospitalizations disrupt this critical period of development, by physically separating mother and infant, altering the traditional parental role and complicating the infant’s exposure to basic early social interaction. NICU follow-up clinics have a unique role in following mother-preterm infant dyads after discharge home, and therefore have an important responsibility to assess ERH risk. The goal of this project is to create an innovative digital tracking measure of ERH. By utilizing efficiently administered and automatically scored ERH screening measures, providers can quickly identify mother-preterm infant dyads at high ERH risk during a busy clinical workflow. Streamlined identification will promote an increased referral stream to existing community resources, as well as provide a support safety net for dyadic needs that might otherwise be missed by primary care providers. |
Optimizing Cardio-Obstetric Care for Patients with Cardiovascular Disease in Pregnancy
| Cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality in the United States, with nearly two-thirds of these deaths being deemed preventable.CVD affects up to 4% of all pregnancies, but accounts for over 25% of maternal deaths and disproportionately affects persons from racial/ethnic minority backgrounds.The objective of this project is to create a multidisciplinary cardio-obstetrics program that will utilize new Epic templates to optimize patient care, improve communication between multiple teams of providers, and will lead to the development of a registry that will allow us to examine the outcomes and management of patients with cardiovascular disease (CVD) in pregnancy. To support these objectives, our proposal includes three phases: 1) Establish a centralized clinic for patients with CVD in pregnancy with infrastructure to include monthly multidisciplinary team meetings focused on antepartum care, delivery planning, and postpartum management, 2) Build an EPIC template that will allow for delivery and treatment plans to be clearly communicated between multiple teams of providers involved in the care of these medically complex patients, and 3) Develop a sustainable registry infrastructure to continually assess our patient outcomes. |
Remote Patient Monitoring Operationalization and Optimization
| As a part of the UMMH system goal of expanding access and capacity to deliver digitally enhanced care to our patients, this project will improve upon and expand the work of the Digital Health Clinic as it focuses on the creation of Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) offerings for our patients. For patients with difficult to control hypertension or diabetes, or those who struggle to reduce BMI, RPM is an efficacious and cost-effective way to extend the reach and understanding of the provider beyond the office visit. It also allows providers a window into the changes in physiology over time when the patient is not in the clinical setting. In combination with a strong and well monitored treatment plan and effective coaching, other disease states such as COPD and CHF can be better controlled. Numerous studies have shown the benefit of RPM both in terms of patient engagement and in real and long-term reductions in blood pressure, hemoglobin A1C, readmissions, and need for emergency care. The current proposal will support faculty time to develop and expand this model and interface with providers across the system to ensure that as many patients as possible benefit from this service. The project will also increase the number of RPM and RTM offerings by working with vendors and clinic partners to ensure that the services needed to impact patients with a variety of conditions are available and easy to access. |
Creation and Implementation of a Real Time Secondary Prevention Osteoporosis Dashboard
| Osteoporosis and its clinical outcome of fragility fracture is an ever-increasing public health problem due to our aging population. US data suggests that once over the age of 50, 1 in 2 women and up to 1 in 4 men will suffer an osteoporotic fracture. Despite awareness of this issue as well as proven therapies for fracture risk reduction, worldwide, clinical assessment and prescription of these therapies after the clinical event of fracture remains disappointingly low. Fracture liaison services have been suggested as a mechanism to bridge this treatment gap and have demonstrated success in a variety of health systems worldwide. The aim of this project is to use prior expertise of creating osteoporosis-related screening and treatment dashboards, to develop and then implement a specific secondary prevention dashboard that can facilitate development of a sustainable local fracture liaison service. | |||
A Clinical Decision Support Tool to Decrease Inappropriate CT PE Utilization
| Most recent data from 2019 estimated 393,000 diagnoses of Pulmonary embolism (PE) within the United States. Of those that are diagnosed, the mortality of this disease process is increasing, and it is estimated that up to 25% of all sudden deaths are thought to be due to a PE. From a global registry, patients with a PE faced a 30- day mortality of 5.02%, with this number nearly doubling if patient were great than 81 years old or had a cancer history. In addition to carrying significant morbidity and mortality, pulmonary embolism is a diagnostic challenge due to its varied presentation and nonspecific symptoms common to many patients presenting to the emergency department. To assist providers in diagnosing a PE a variety of clinical decision rules (CDR) have been prospectively developed and validated to risk stratify patients and avoid CT imaging in low risk patients. Despite these well validated CDRs in the medical literature, they have not consistently translated to clinical practice resulting in frequent utilization of computerized topography (CT) scan to rule out PE. This overutilization of CT scans leads to many detrimental downstream effects for patients, emergency department throughput, radiology efficiency and healthcare expenditures. The primary goal of this project is to develop a clinical decision support tool through Epic to interface with providers when a CT PE scan is ordered to promote the translation of validated CDR into clinical practice. |
Improving Treatment Pathways for Depression in Primary Care Utilizing Digital Health Resources
| Depression is a common, disabling, and sometimes lethal heterogeneous condition for which primary care providers are expected to screen, diagnose, and initiate treatment: an estimated 60% of mental health delivery occurs in primary care settings, and 79% of antidepressant prescriptions are written by providers who are not mental health professionals. It is imperative to explore new tools and strategies to support primary care providers. Digital health provides potent tools for treating depression and is supported by a growing evidence base. The project proposes to use existing EPIC functionality for primary care providers to refer patients to digital mental health applications that support psychoeducation, self-help resources, brief cognitive behavioral therapy, mindfulness, and mood tracking. Specifically, the team will review available digital tools based on effectiveness and cost considerations; will work with primary care providers and leadership to develop a simple EPIC-based tool to connect patients to digital devices; and will monitor the use and effectiveness of the intervention using currently available data sets. |
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