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处于十字路口:国家远程医疗研究与转化中心白皮书探讨推动远程医疗、电子健康记录和健康信息交换融合的趋势。

At the crossroads: NRTRC white paper examines trends driving the convergence of telehealth, EHRs and HIE.

作者信息

Thielst Christina Beach

机构信息

Northwest Regional Telehealth Center, USA.

出版信息

World Hosp Health Serv. 2010;46(4):17-23.

PMID:21391447
Abstract

From the American Recovery and Reinvestment Act (ARRA) and the newly passed healthcare reform legislation to emerging reimbursement models and shifting consumer health trends, a confluence of events are driving radical change in the nation's healthcare system and bringing about the convergence of telehealth, electronic health records (EHRs) and health information exchange (HIE). That is the focus of "The Crossroads of Telehealth, Electronic Health Records & Health Information Exchange: Planning for Rural Communities," a new white paper from the Northwest Regional Telehealth Resource Center (NRTRC). "Accelerating adoption and utilization of telehealth technologies, telemedicine in particular, will be critical to a successful stakeholder response to the disruptive changes that are underway in healthcare," said NRTRC Executive Director Christina B. Thielst, FACHE. "By leveraging telehealth networks and their existing infrastructures, Regional Extension Centers, HIEs and other data-sharing initiatives will be better-positioned to fulfill their commitments to the healthcare delivery system of the future--a system in which even the most rural and remote populations have timely access to care and their health records." The white paper explores emerging trends and recent disruptors impacting the healthcare delivery system and examines the opportunities they present for the advancement of telecommunications-based health solutions and the broadband infrastructure available through telehealth networks. It also takes an in-depth look at the various uses of telehealth and the most common delivery models of telemedicine, as well as the role of the telehealth network and Telehealth Resource Centers (TRCs) in expanding the reach of these vital initiatives. Finally, the white paper highlights the evolution of the REACH Montana Telehealth Network from facilitating teleradiology at three remote sites into a consortium of healthcare providers at 18 sites linked by high-bandwidth telecommunications in the north central region of Montana. REACH, which considers HIE to be a primary function, is currently working to leverage its existing T1 infrastructure to create the "railroad tracks" that will carry medical data and information within the region and beyond. "This white paper is an excellent analysis of the intersection of telehealth and health information technology, and the opportunities and challenges this electronic technology will bring to rural America," said Terry J. Hill, Executive Director of the Rural Health Resource Center, the Duluth, Minn.-based national knowledge center for rural hospitals providing technical assistance, information, education and other resources to rural health care providers and their communities. Adds Thielst: "Crossroads is a valuable planning tool for any healthcare stakeholder, but it is especially important for rural communities wanting to address health information exchange. It is just one of many resources available through the NRTRC to help advance the involvement of teleheatlh networks in HIE initiatives and to help transform the telehealth infrastructure into the 'superhighway' across which remote and rural areas will finally be able to participate in the widespread exchange of electronic health information." One of five TRCs in the nation, the NRTRC leverages the collective expertise of 33 telehealth networks across Alaska, Hawaii, Idaho, Montana, Oregon, Utah, Washington, Wyoming, and United States-affiliated Pacific Islands to share information and resources which assist in the development of new telehealth programs. The NRTRC is focused on further growth and new provider adoption of telehealth technologies to enhance delivery systems and reduce organizational and patient costs.

摘要

从《美国复苏与再投资法案》(ARRA)、新通过的医疗改革立法,到新兴的报销模式以及不断变化的消费者健康趋势,一系列事件正在推动美国医疗体系发生根本性变革,促使远程医疗、电子健康记录(EHR)和健康信息交换(HIE)相互融合。这正是西北区域远程医疗资源中心(NRTRC)发布的新白皮书《远程医疗、电子健康记录与健康信息交换的十字路口:农村社区规划》的核心内容。NRTRC执行董事克里斯蒂娜·B·蒂尔斯特(FACHE)表示:“加速远程医疗技术,尤其是远程医疗的采用和应用,对于利益相关者成功应对医疗领域正在发生的颠覆性变革至关重要。通过利用远程医疗网络及其现有基础设施,区域扩展中心、HIE以及其他数据共享计划将更有能力履行其对未来医疗服务体系的承诺——在这个体系中,即使是最偏远的农村人口也能及时获得医疗服务并获取自己的健康记录。”该白皮书探讨了影响医疗服务体系的新兴趋势和近期干扰因素,并审视了它们为基于电信的健康解决方案和通过远程医疗网络提供的宽带基础设施发展带来的机遇。它还深入研究了远程医疗的各种用途和远程医疗最常见的服务模式,以及远程医疗网络和远程医疗资源中心(TRC)在扩大这些重要计划覆盖范围方面的作用。最后,白皮书重点介绍了蒙大拿州REACH远程医疗网络的发展历程,该网络从在三个偏远地点提供远程放射学服务发展成为一个由蒙大拿州中北部18个地点的医疗服务提供商组成的联盟,这些地点通过高带宽电信连接。REACH将HIE视为主要功能,目前正努力利用其现有的T1基础设施创建“铁轨”,以便在该地区及其他地区传输医疗数据和信息。明尼苏达州德卢斯的农村健康资源中心执行董事特里·J·希尔表示:“这份白皮书对远程医疗与健康信息技术的交叉领域以及这项电子技术将给美国农村带来的机遇和挑战进行了出色的分析。”农村健康资源中心是一家为农村医院提供技术援助、信息、教育及其他资源的全国性知识中心。蒂尔斯特补充说:“《十字路口》对任何医疗利益相关者来说都是一个有价值的规划工具,对于希望解决健康信息交换问题的农村社区尤其重要。这只是NRTRC提供的众多资源之一,有助于推动远程医疗网络参与HIE计划,并帮助将远程医疗基础设施转变为‘高速公路’,偏远和农村地区最终将能够通过这条‘高速公路’参与广泛的电子健康信息交换。”作为美国五个TRC之一,NRTRC利用阿拉斯加、夏威夷、爱达荷州、蒙大拿州、俄勒冈州、犹他州、华盛顿州、怀俄明州以及美国附属太平洋岛屿上33个远程医疗网络的集体专业知识,共享信息和资源,以协助开发新的远程医疗项目。NRTRC专注于远程医疗技术的进一步发展以及新的医疗服务提供商对其的采用,以改善医疗服务体系并降低机构和患者成本。

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