Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Am J Prev Med. 2011 May;40(5 Suppl 2):S217-24. doi: 10.1016/j.amepre.2011.01.012.
Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear.
To develop a HIT-based data infrastructure that serves multiple hospice and palliative care sites, meeting clinical and administrative needs with data, technical, and analytic support.
Through a multi-site academic/community partnership, a data infrastructure was collaboratively developed, pilot-tested at a community-based site, refined, and demonstrated for data collection and preliminary analysis. Additional sites, which participated in system development, became prepared to contribute data to the growing aggregate database.
Electronic data collection proved feasible in community-based hospice and palliative care. The project highlighted "success factors" for implementing HIT in this field: engagement of site-based project "champions" to promote the system from within; involvement of stakeholders at all levels of the organization, to promote culture change and buy-in; attention to local needs (e.g., data for quality reporting) and requirements (e.g., affordable cost, efficiency); consideration of practical factors (e.g., potential to interfere with clinical flow); provision of adequate software, technical, analytic, and statistical support; availability of flexible HIT options (e.g., different data-collection platforms); and adoption of a consortium approach in which sites can support one another, learn from each others' experiences, pool data, and benefit from economies of scale.
In hospice and palliative care, HIT-based data collection/management has potential to generate better understanding of populations and outcomes, support quality assessment/quality improvement, and prepare sites to participate in research.
很少有临终关怀和姑息治疗组织使用健康信息技术（HIT）进行数据收集和管理；在这种多方面、跨学科的背景下，基于 HIT 的方法的可行性和实用性尚不清楚。
开发一种基于 HIT 的数据基础设施，为多个临终关怀和姑息治疗场所提供服务，通过数据、技术和分析支持满足临床和管理需求。
通过多站点学术/社区合作，共同开发数据基础设施，在社区为基础的场所进行试点测试、改进，并展示用于数据收集和初步分析。参与系统开发的其他场所已准备好将数据贡献到不断增长的综合数据库中。
电子数据收集在社区为基础的临终关怀和姑息治疗中是可行的。该项目突出了在该领域实施 HIT 的“成功因素”：让基地项目的“拥护者”参与进来，从内部推动系统；让组织各级利益相关者参与进来，促进文化变革和认同；关注当地的需求（例如，用于质量报告的数据）和要求（例如，负担得起的成本、效率）；考虑实际因素（例如，潜在的干扰临床流程）；提供充足的软件、技术、分析和统计支持；考虑灵活的 HIT 选择（例如，不同的数据收集平台）；并采用联盟方法，使各场所能够相互支持、从彼此的经验中学习、汇集数据，并从规模经济中受益。
在临终关怀和姑息治疗中，基于 HIT 的数据收集/管理有可能更好地了解人群和结果，支持质量评估/质量改进，并使各场所能够准备参与研究。
