# Records for Alcohol Care Enhancement (RACE)

> **NIH NIH R21** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2020 · $193,161

## Abstract

PROJECT SUMMARY
Unhealthy alcohol use (the spectrum from risky consumption through alcohol use disorder, AUD) is a leading
cause of preventable death, and alcohol-related health harms (e.g. AUD itself, cirrhosis) are increasing. Most
people with unhealthy use receive no effective interventions despite the high frequency of contact with medical
care. Electronic health records (EHRs) can be leveraged to improve the identification and effective treatment of
AUD. Some integrated health systems have leveraged EHRs but examples not supported by such substantial
infrastructure are uncommon, and the full potential to manage populations in accountable care organizations
beyond screening and brief preventive counseling has not been realized. This research is aimed at improving
services for AUD by using EHRs to support individual care and population health management in urban
primary care based at a hospital with an accountable care organization (ACO) in a diverse underserved
community. The over-arching goal of the proposed project (RACE-Records for Alcohol Care Enhancement) is
to use data already being collected in routine clinical practice in EHRs to improve clinical identification and
management of people with AUDs. To achieve that goal we will, in the first phase of this project, 1) create a
clinically useful live database of patients with unhealthy alcohol use and implement prompts and decision
support (“best practice advisory” or alert, BPA) and practice level monitoring in an urban underserved
community ACO, 2) access and automate linkage of inpatient and outpatient (including emergency department
visit) EHR data and primary care in-person-collected alcohol screening data, 3) create a usable registry of
primary care patients with alcohol use disorder from the linked EHR and screening data, 4) adapt the EHR to
create a best practice advisory to alert clinicians of their patients’ unhealthy alcohol use and provide guidance
for clinical action, and then 5) create a data collection and capture method to monitor and report on alcohol use
and alcohol consequence-related healthcare visits for the panel of patients in the registry at the individual and
practice levels before and after implementation of the EHR changes. In the second phase of the project, we will
test feasibility and obtain preliminary effectiveness estimates in a 4-arm randomized trial comparing EHR 1)
clinician prompting and decision support best practice advisory alone (BPA), 2) BPA plus population health
management (BPA+PHM), 3) BPA plus clinical care management (BPA+CCM) and 4) all three
(BPA+PHM+CCM), to improve AUD care. We hypothesize that compared to BPA alone (arm 1), PHM (arm 2)
and CCM (arm 3) separately and all 3 together (arm 4) will improve engagement (a national quality of care
measure), receipt of AUD medication, AUD counseling, and specialty AUD care by referral. The study will
demonstrate the feasibility of leveraging EHRs in widespread use, and will inform likely effective...

## Key facts

- **NIH application ID:** 9928726
- **Project number:** 5R21AA027597-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** RICHARD SAITZ
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $193,161
- **Award type:** 5
- **Project period:** 2019-05-20 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928726

## Citation

> US National Institutes of Health, RePORTER application 9928726, Records for Alcohol Care Enhancement (RACE) (5R21AA027597-02). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9928726. Licensed CC0.

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