Mixed-methods study of integration of housing and medical data systems for enhanced service coordination of people with HIV

IF 0.8 Q4 NURSING
Vivian L Towe, L. Bogart, R. McBain, Lisa Wagner, Clare Stevens, S. Fischer, S. MacCarthy
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引用次数: 5

Abstract

Introduction Housing is a determinant of HIV-related medical outcomes. Care coordination has been successfully used to treat patients with HIV and can be improved through electronic exchange of patient data, including housing data. Methods Primary data were collected from four sites across the U.S., each comprising partnerships between local HIV medical and housing providers. Between March 2017 and May 2018, we conducted a mixed-methods evaluation, focusing on preparatory activities, implementation of tasks related to data integration, and service coordination. Nineteen focus group discussions were conducted with providers, organizational leaders, and clients. Ten interviews were conducted with data system vendors and administrators. Site visits, logs, and progress reports provided information about data integration progress and other activities. Results Key activities included changes to client consent, setting up data use agreements, and planning with data system vendors. Sites selected one of three models: one-way data transmission between two systems, bidirectional transmission between two systems, and integration into one data system. Focus group discussion themes included: challenges of using existing data systems; concerns about the burden of learning a new data system; and potential benefits to providers and client, such as having more time to spend delivering client services. Discussion Using health information technologies to share data has widespread support, but uptake is still met with resistance from end users. The additional level of complexity differentiating this study from others is the exchange of data between service providers and care providers, but sites were able to accomplish this goal by navigating extensive barriers.
整合住房和医疗数据系统以加强对艾滋病毒感染者的服务协调的混合方法研究
引言住房是艾滋病毒相关医疗结果的决定因素。护理协调已成功用于治疗艾滋病毒患者,并可通过包括住房数据在内的患者数据的电子交换加以改进。方法从美国四个地点收集主要数据,每个地点都包括当地HIV医疗和住房提供者之间的合作伙伴关系。2017年3月至2018年5月,我们进行了一次混合方法评估,重点是准备活动、数据集成相关任务的执行和服务协调。与供应商、组织领导和客户进行了19次焦点小组讨论。对数据系统供应商和管理员进行了10次访谈。现场访问、日志和进度报告提供了有关数据集成进度和其他活动的信息。结果关键活动包括更改客户同意书、制定数据使用协议以及与数据系统供应商进行规划。站点从三种模式中选择一种:两个系统之间的单向数据传输、两个系统间的双向传输以及集成到一个数据系统中。焦点小组讨论的主题包括:使用现有数据系统的挑战;担心学习新数据系统的负担;以及对提供商和客户的潜在好处,例如有更多的时间用于提供客户服务。讨论使用健康信息技术共享数据得到了广泛支持,但最终用户仍对其使用表示抵制。这项研究与其他研究不同的另一个复杂性是服务提供商和护理提供商之间的数据交换,但网站能够通过克服广泛的障碍来实现这一目标。
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来源期刊
CiteScore
3.10
自引率
14.30%
发文量
15
期刊介绍: The International Journal of Care Coordination (formerly published as the International Journal of Care Pathways) provides an international forum for the latest scientific research in care coordination. The Journal publishes peer-reviewed original articles which describe basic research to a multidisciplinary field as well as other broader approaches and strategies hypothesized to improve care coordination. The Journal offers insightful overviews and reflections on innovation, underlying issues, and thought provoking opinion pieces in related fields. Articles from multidisciplinary fields are welcomed from leading health care academics and policy-makers. Published articles types include original research, reviews, guidelines papers, book reviews, and news items.
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