Initial meeting:

Connection to the EHR - dashboard
Epic1 research governance approval
Limit to WashU providers
Allow school nurses to access that data.
We can help draft IRB info.
How do we get the school data - a system we can access? School's have a system where they track this data. Kelly isn't sure what exactly that system is. Start with just the Epic data first.
Initially wrote for a single district, multiple school pilot.
How do we restrict a patient to a school? Also, family will need to consent at the beginning of the school year. We could leverage Redcap for the consents to send to parents that are interested in participating and they could enter some of that information. Then map that data to a list of nurses to student to school. In that student data in the backend we could link on the backend to the Epic MRN.
Could we from that create an easily accessible dashboard for the nurses with an iPad? Probably leverage Tableau to create the dashboard, and then embed that into a custom website of some sort.
Could take out the Redcap middleman and build a custom app with website and dashboard and that can get really expensive.
40 hours just to do the website. 10-20 for the dashboard. data query work 10-20 hours.
She is suggesting use Redcap, create tableau dashboard, and after a while remove the redcap for scaling.
Everyone is used to consenting in Redcap so it gets through IRB easier and reduces the amount of custom built items.
Regarding Tableau, how difficult will that be to put in guardrails for access? The education data warehouse is built in Tableau so it has to be possible.
Kelly is resubmitting a grant for this. Needs two things: she needs to add additional details in the proposal as a budget and SOW.
Ian will check with team on Tableau website piece within the PE team. If more effort than we have resources for, we can bring in Hicapps. Suggested she pad her estimates.
We can write a letter of support if she needs it. Albert could do that. We can give a budget estimate and scope.

Timeline: Grant submission due 2nd week of September.
Action items: SOW - map it out and answer some follow-up questions. Provide that within 10 days max. Ck with PE team. Ask Brokers how complex the query may be. Give Albert the SOW so he can write an LOS.

PE-10 Development of a School-Based Care Coordination Service Model to support : Youth with Asthma
We are hoping to develop an EPIC/EHR linked dashboard to facilitate care coordination between providers and school nurses for youth with asthma. For the development and testing, the school nurses would be engaged as members of the research team to address confidentiality and compliance concerns. We are hoping to identify potential developers to work with on this project.

8/5/2024 Meeting

*Follow-up:
*US: Cost estimate - first draft SOW from Brokerage and PE that frames the process and estimates hours. Send some snapshots of different dashboards for their review.
Them: Is the action plan discreet?
From a partnership with school personnel. Asthma management, kids going out to appts and ED, and there is not follow-up for school nurses and no action plans for kids high risk for asthma problems or for asthma sufferers. Tie the EMR to school data for the nurses. MyChart-esque tool that allow providers to have the asthma action plan and that to get to the school. We want to pull out that similar information to a dashboard for school nurses to use without the parents and providers having to do the extra work.

• Pull data from Epic to the dashboard
• Pull school data into the dashboard
  Initial aim is to pilot the study. They will need to enroll them in Epic but also consent them for the study. They would also need to consent for their data to be shared. So they would enroll at the school and in the study through Epic.
  We would need to restrict the access to what they are pulling from Epic to the providers at the school. ex. 4 different IRB Citi trained nurses that are part of the research team. Once it expands, it would probably still be restricted. Only visible to enrolled students at the school.
  Data: action plan (a stand form/its own tab on MyChart the provider fills out and signs that is viewable as a sheet and Kelly can download); additional data not limited and go through an engagement process with parents to find a comfort level. ED visits, etc. She thinks just the summary right now. Julia: would we want to just pull primary dx from ED visits that are asthma related? or any dx related to ED visit that has an asthma dx?
  Include any information that is helpful for their care. In-patient stays, all ED encounters, and hospitalizations. How far back does data go? 2 years prior and follow for 1 year after. Need to consider when to roll them out. They will have to think about a yearly enrollment. Scalable and able to follow kids more broadly in the region (school moves, etc.)
  Ex. 6-9 iterative meetings plus a cushion.
  September funding. Money maybe in April. Pilot for the full school year (9-10 months) summer/Aug 2025 or even 2026. Not a rush-take the time needed to develop it and get input from all the relevant parties. Iterative developing and prototyping.
  4-5 yr mechanism grants. POC, can it be done, does it work, and does it help, while also considering the privacy and confidentiality with the two systems and HIPAA and FERPA.
  She initially penned in 144 in yr 1 (design, workshopping, iterations), 192 in yr 2 (supplemental development), 96 in yr 3 (monitoring) and 96 in yr 4. for a total of 672 hrs for informatics support.
  Nurses need to be able to use a tablet to access and put in their own information to go back to the providers. Also, add additional educational content for parents/students.
  We will need to involve InfoSec and consider account management and app upkeep going forward.
  EPIC feedback
  Epic care link or Share Anywhere (will be limited to 24 hrs so not an option.)
  With Carelink, the coordinator adds the participants to the study in Epic and it is customizable. Sherry reached out to the epic research team to find out if we have used this at WU beyond monitors. The asthma study team will have to manage it all.

Meeting: Discussion w/ Sherry & Nicole 2024-08-27

• Needs to be discussed with Albert
• Planned for next week
• Doing discovery on what tools may be available. Pending direction from leadership.
• Exploring using CareEverywhere
• Plan B is use the EpicCare Link monitors(?) will need Epic1 team to manage this
• Need to meet with the team and Sherry

• Meeting: Discussion 2024-10-30

• Engage the nurses as if they are part of the research team to help with some of the IRB hurdles. But how to move forward with EpicCare Link? Sherry thinks they would have access to too much information. Could a request be a limited number of nurses to a limited number of participants. To limit the records they can see, but how much of a lift is this for the epic team?
• Here are a few notes to help us stay on track.

1. Kelly will prep slides and send them to Sherry before November 18 so she can present to BJC/WU legal/HIPAA meeting on November 21.
2. Kelly will investigate what the nurses would need to gain access to EpicCare Link.

• Epic1: Will Cusick Proj Mgr William.Cusick@bjc.org and Sam Neudecker Epic1 Research Analyst Samuel.Neudecker@bjc.org
• HRPO: Christine Schorb schorbc@wustl.edu

3. Our team will join Kelly’s research team in mid-late November (tentative 11/20).
4. After feedback from the 11/21 meeting, update slides and Kelly join Sherry in a Research Steering Committee (meets monthly) meeting with the proposal to get approval.
5. Submit form to Epic1 team.
   Bill her for the time. Check with Sherry on a preliminary phase 1 SOW