建立一个以患者为中心的通用健康记录共享平台

IF 3.4 3区 医学 Q1 HEALTH POLICY & SERVICES
Mana Azarm , Rebecca Meehan , Craig Kuziemsky
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引用次数: 0

摘要

目的本文提供了一种实用的方法来评估健康记录共享平台在系统级别提供可互操作的高质量医疗保健的能力。我们使用我们之前发布的互操作性评估框架,将我们提出的系统级记录共享(SLRS)平台与加拿大、美国和挪威的其他四类常见的健康记录共享平台进行评估。我们使用我们提出的基于四重目标、三重目标和加拿大卫生信息研究所(CIHI)健康平台评估框架的评估框架,对5类医疗平台进行了比较评估:SLRS、商业多平台(CM)、商业独立平台(CI)、政府多平台(GM)和政府独立平台(GI)。结果SLRS和由政府组织管理的提供技术独立或兼容平台的平台在满足数据互操作性、提供有意义和有效的信息交换、在各种情况下遵守健康隐私法规以及在中央层面支付许多成本方面是最有效的。所有平台都在努力满足上下文和流程互操作性要求,并在整个卫生系统中提供循证信息。结论为了优化健康管理,临床医生和患者都需要跨应用程序共享个人健康信息(PHI)。我们的研究结果表明,本研究中的商业平台需要改进其治理结构,并采用可被整个卫生系统的所有EHR应用程序采用的一致本体。我们提出的SLRS平台可以在系统级别支持多个医疗保健组织之间的健康数据共享,使临床医生能够访问患者健康数据,为治疗和护理决策提供信息。公共利益抽象医疗保健组织在跨国界交换信息时面临障碍。许多障碍是由EHR应用程序的不同技术要求及其上下文规定造成的。大多数医疗机构都有一个门户网站,患者可以在其中查看他们的护理历史。然而,所提供信息的广度限制了订阅该特定平台的医疗保健提供者的数量。查看整个卫生系统的完整历史记录需要维护多个帐户。在本文中,我们参考了一个新的健康信息共享框架及其原型平台(SLRS),该框架是我们之前在实验室中开发的。在本文中我们报告了我们如何根据健康信息交换的四个突出实践来评估SLRS平台。我们使用了我们的互操作性评估框架,该框架是根据文献和实践中公认的标准开发的。我们发现了现有健康信息平台需要改进的地方,这样他们就可以在整个卫生系统中共享自己的记录。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Towards a universal patient-centric health record sharing platform

Objectives

This paper provides a practical approach to evaluate health record sharing platforms in terms of their ability to deliver interoperable healthcare of quality at a systems level. We use our previously published interoperability evaluation framework to evaluate our proposed System-level Record Sharing (SLRS) platform against four other common categories of health record sharing platforms in Canada, the United States, and Norway.

Methods

In this paper, we compare the SLRS platform architecture that we previously developed against 4 health record sharing platform categories. We conducted this comparative evaluation of 5 categories of healthcare platforms: SLRS, Commercial-Multi (CM), Commercial-Independent (CI), Governmental-Multi (GM), and Governmental-Independent (GI) using our proposed evaluation framework that is built upon quadruple aim, triple aim and Canadian Institute for Health Information (CIHI) health platform evaluation frameworks.

Results

SLRS and platforms managed by government organizations that provide a technology-independent or compatible platform were the most effective in terms of satisfying data interoperability, providing meaningful and effective information exchange, being compliant with health privacy regulations across a range of contexts, and having many of the costs paid for at a central level. All platforms struggled with context and process interoperability requirements, as well as providing evidence-based information across an entire health system.

Conclusion

To optimize health management, both clinicians and patients need sharing of personal health information (PHI) across applications. Our findings indicate that commercial platforms in this study need to improve their governance structure and employ a consistent ontology that can be adopted by all EHR applications across a health system. Our proposed SLRS platform can support the sharing of health data across multiple health care organizations at a system-level, allowing clinicians to access patient health data to inform treatment and care decisions.

Public interest abstract

Healthcare organizations face barriers when exchanging information across their boundaries. Many obstacles are caused by varying technical requirements of the EHR applications they have, and their contextual regulations. Most healthcare organizations have a portal in which the patients can view their care history. However, the breadth of the information provided limits to the number of healthcare providers subscribed to that specific platform. Viewing the full history across the entire health system, requires maintaining multiple accounts.

In this paper we refer to a new framework for sharing health information and its prototyped platform (SLRS) that we have previously developed in our lab. In this paper we report on how we evaluated the SLRS platform against four prominent practices of Health Information Exchange. We used our interoperability evaluation framework that was developed based on well-acknowledged criteria from literature and practice. We found areas of improvement for existing health information platforms so they can share their records across an entire health system.

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来源期刊
Health Policy and Technology
Health Policy and Technology Medicine-Health Policy
CiteScore
9.20
自引率
3.30%
发文量
78
审稿时长
88 days
期刊介绍: Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments. HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology. Topics covered by HPT will include: - Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems - Cross-national comparisons on health policy using evidence-based approaches - National studies on health policy to determine the outcomes of technology-driven initiatives - Cross-border eHealth including health tourism - The digital divide in mobility, access and affordability of healthcare - Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies - Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies - Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making - Stakeholder engagement with health technologies (clinical and patient/citizen buy-in) - Regulation and health economics
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