title: Next-generation long-term transplant clinics: improving resource utilization and the quality of care through health information technology.
abstract: By the year 2020, potentially one-half a million hematopoietic cell transplant (HCT) recipients will need long-term follow-up care to address not only chronic GvHD but also multiple other late consequences of transplant. Despite this increase in patients, there will not be a concomitant increase in the HCT workforce. Thus, the future of long-term patient management will require a new 'next-generation' clinical model that utilizes technological solutions to make the care of the HCT patient efficient, safe and cost-effective. Guideline-based decision support will be embedded in clinical workflows. Documentation requirements will be reduced as automated data collection from electronic medical records (EMRs) will populate registries and provide feedback for a rapid learning health system. Interoperable EMRs will disseminate treatment protocols to multiple care providers in a distributed long-term clinic model, such that providers outside of the transplant center can provide services closer to the patient. Patients will increase their participatory role through patient portals and mobile devices. At Vanderbilt, we have responded to some of these future challenges by embedding guideline-based decision support, structuring clinical documentation and being early adopters of communication technology. This manuscript describes the current state of some of these innovations, and a vision for the future of the long-term transplant clinic.
authors.affiliation: Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rioth
authors.affiliation: Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-2851-7242
authors.initials: J
authors.lastname: Warner
authors.affiliation: Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Jagasia
mesh_terms: D064591:Allografts; D018380:Hematopoietic Stem Cell Transplantation; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods*; D006801:Humans; D008490:Medical Informatics; D011787:Quality of Health Care