Center for Health Policy and Inequalities Research, Duke University, Durham, NC 27705, United States.
Int J Med Inform. 2012 Oct;81(10):e46-55. doi: 10.1016/j.ijmedinf.2012.07.009. Epub 2012 Aug 13.
The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties.
Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention.
We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close.
Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities.
区域卫生信息集成项目 (RHIIP) 已开发出卡罗莱纳艾滋病毒信息合作区域卫生信息组织 (CHIC RHIO)。建立 CHIC RHIO 的目的是通过加强北卡罗来纳州农村地区艾滋病毒护理提供者之间的地理上分散的网络之间的沟通，改善患者护理和健康结果。CHIC RHIO 由一个医疗诊所和五个艾滋病服务组织 (ASO) 组成，为八个农村县的客户提供服务。
CHIC RHIO 成员之间的沟通是通过 CAREWare 软件进行的。RHIIP 团队评估了组织变革的准备情况，为 CHIC RHIO 建立了关系，创建了 CHIC RHIO，并采用定性和定量方法评估了实施数据共享干预措施的过程相关效果。
我们发现，在实施 IT 干预措施之前，CHIC RHIO 成员组织已经准备好参与其中，这很可能是其成功采用的原因。定性研究结果表明，CHIC RHIO 成员个人受益——并且认为他们的客户受益——从参与信息交流中受益。定量结果与定性研究结果一致；在 CHIC RHIO 干预措施之后，ASO 和医疗诊所的关系、信息交流以及感知的患者护理水平都有所改善。此外，由于项目即将结束，项目开始时对数据共享所能完成的期望过高，因此需要重新调整预期。
可以在农村社区实施创新的卫生信息交换策略，以增加提供者之间的沟通。随着这种沟通的增加，有可能改善健康结果，进而改善社区的健康状况。
