Indiana University-Purdue University Indianapolis, School of Liberal Arts, The Polis Center, Indianapolis, IN 46202, USA.
Public Health Rep. 2011 Sep-Oct;126 Suppl 3(Suppl 3):54-61. doi: 10.1177/00333549111260S310.
Linking electronic health record (EHR) systems with community information systems (CIS) holds great promise for addressing inequities in social determinants of health (SDH). While EHRs are rich in location-specific data that allow us to uncover geographic inequities in health outcomes, CIS are rich in data that allow us to describe community-level characteristics relating to health. When meaningfully integrated, these data systems enable clinicians, researchers, and public health professionals to actively address the social etiologies of health disparities.This article describes a process for exploring SDH by geocoding and integrating EHR data with a comprehensive CIS covering a large metropolitan area. Because the systems were initially designed for different purposes and had different teams of experts involved in their development, integrating them presents challenges that require multidisciplinary expertise in informatics, geography, public health, and medicine. We identify these challenges and the means of addressing them and discuss the significance of the project as a model for similar projects.
将电子健康记录 (EHR) 系统与社区信息系统 (CIS) 相连接,对于解决健康社会决定因素 (SDH) 方面的不平等问题具有很大的潜力。虽然 EHR 中包含丰富的特定于位置的数据,这些数据使我们能够揭示健康结果在地理上的不平等,但 CIS 中包含丰富的数据,这些数据使我们能够描述与健康相关的社区层面的特征。当这些数据系统得到有意义的整合时,临床医生、研究人员和公共卫生专业人员就能够积极解决健康差异的社会病因。本文描述了一个通过地理编码探索 SDH 的过程,即将覆盖一个大都市地区的 EHR 数据与一个综合性的 CIS 进行整合。由于这些系统最初是为不同的目的而设计的,并且有不同的专家团队参与其开发,因此将它们整合起来存在挑战,这需要在信息学、地理学、公共卫生和医学方面具备多学科专业知识。我们确定了这些挑战及其解决方法,并讨论了该项目作为类似项目模型的意义。