An Internet-Based Evaluation System for Postacute Acquired Brain Injury

DESCRIPTION (provided by applicant): The overall objective of this project is to develop a national database system for an assessment and outcome measure (Mayo-Portland Adaptability Inventory; MPAI-4) for acquired brain injury (ABI). The proposed database will provide a representative sample of demographics, social and treatment environments, diagnosis/injury descriptors, change over the course of postacute rehabilitation, and outcomes. This database will be used to provide semi-annual feedback to participating providers about the effectiveness of their rehabilitation services relative to those of other providers serving similar individuals and using similar methods. The psychometric properties and usability of the MPAI-4 have been refined over the last 15 years using state-of-the-art measurement technology (e.g., Rasch analysis) as well as traditional psychometric evaluation procedures. A prototype MPAI-4 database was developed with a small user group in Pennsylvania by Inventive Software Solutions (ISS). The proposed project will use state-of-the-art database technologies (e.g., secure web-based, on-line data collection). Through focus group, usability testing, and expert consultation, the prototype system will be further developed into a secure, user-friendly, informative, and practical patient and program evaluation system for commercialization on a national level. Specific Aims for Phase I are: (1) Based on feedback from current users of the ISS MPAI-4 database system prototype, further develop and refine the prototype to include: (a) secure and user-friendly web interface for data acquisition; (b) data synthesis based on multiple sites including background computations and data checks; (c) standardized bi-annual report format designed to meet provider and consumer needs; (2) Assess general usability of the refined MPAI-4 database system and reports from focus groups of current users of the ISS prototype as well from other MPAI-4 users and consumer stakeholders in other areas of the U.S.; (3) Develop policies, procedures and an organizational structure to assure patient confidentiality, scientific integrity, commercial viability, and to address other ethical and regulatory concerns in the long term commercialization of this product. Relevance: Methods for program evaluation are required by the Committee on the Accreditation of Rehabilitation Facilities (CARF). The MPAI-4 is a measurement tool that can meet the critically unmet need for a national database system for gathering information from rehabilitation providers to be used for the evaluation of rehabilitative services for people with acquired brain injury (ABI). In addition to the immediate goal of commercialization and dissemination of this program evaluation product, ultimately data obtained may be useful for advocacy, policy development, disability determination, and determination of needs for medical, rehabilitation, vocational, independent living and other services of people with ABI.