Overhage J Marc, Evans Lori, Marchibroda Janet
Associate Professor, Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd, Indianapolis, IN 46202-2872, USA.
J Am Med Inform Assoc. 2005 Mar-Apr;12(2):107-12. doi: 10.1197/jamia.M1680. Epub 2004 Nov 23.
The Secretary of Health and Human Services recently released a report calling for the nation to create a national health information network (NHIN) that would interconnect Regional Health Information Organizations (RHIOs). These RHIOs, which others have called Local or Regional Health Information Infrastructures (LHII), would in turn interconnect local as well as national health information resources. Little data exist about the activities taking place in communities to create LHIIs.
The authors analyzed data that communities submitted in response to a request for capabilities issued by the Foundation for eHealth as part of their Connecting Communities for Better Health program using descriptive statistics and subjective evaluation.
The authors analyzed data from 134 responses from communities in 42 states and the District of Columbia. Communities are enthusiastic about moving forward with health information exchange to create LHIIs to improve the efficiency, quality, and safety of care. They have identified significant local sources of investment and plan to use some clinical data standards but not as broadly as was expected. The communities have not yet developed the specific technical approaches or the sustainable business models that will be required. Many communities are interested in creating an LHII and are developing the leadership commitment needed to translate that interest into an operational reality. Clinical information standards can be incorporated into a community's plans as often as they need to be. Communities have to overcome funding issues, develop deeper understanding of the technical and organizational issues, and aggressively share their learning to succeed within their community and to help other communities succeed.
美国卫生与公众服务部部长最近发布了一份报告,呼吁美国建立一个全国性卫生信息网络(NHIN),该网络将把区域卫生信息组织(RHIO)连接起来。其他人将这些RHIO称为地方或区域卫生信息基础设施(LHII),而这些LHII反过来又会连接地方和全国性的卫生信息资源。关于社区中建立LHII的活动,现有数据很少。
作者分析了社区针对电子健康基金会在其“连接社区,促进健康”计划中发布的能力要求而提交的数据,采用了描述性统计和主观评估方法。
作者分析了来自42个州和哥伦比亚特区的134个社区的回复数据。社区对于推进卫生信息交换以创建LHII来提高医疗效率、质量和安全性充满热情。他们已经确定了重要的地方投资来源,并计划使用一些临床数据标准,但使用范围没有预期的那么广泛。这些社区尚未开发出所需的具体技术方法和可持续商业模式。许多社区有兴趣创建LHII,并正在培养将这种兴趣转化为实际行动所需的领导承诺。临床信息标准可以根据需要随时纳入社区计划。社区必须克服资金问题,更深入地了解技术和组织问题,并积极分享经验,以便在本社区取得成功并帮助其他社区取得成功。