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四个国家利用卫生信息技术支持慢性病患者护理的比较。

A comparison of how four countries use health IT to support care for people with chronic conditions.

机构信息

Julia Adler-Milstein (

Nandini Sarma is a research assistant in the Department of Health Policy and Management at the Harvard School of Public Health, in Boston, Massachusetts.

出版信息

Health Aff (Millwood). 2014 Sep;33(9):1559-66. doi: 10.1377/hlthaff.2014.0424.

Abstract

Countries around the globe are investing in health information and communications technologies (ICTs) as critical tools for improving care for chronically ill patients. We profiled four high-income nations with varied health ICT strategies--Australia, Canada, Denmark, and the United States--to describe their use of ICTs to improve chronic care. Our goal was to identify common challenges and opportunities for cross-national learning. We found four key themes. First, although all four countries have a national strategy for health ICT adoption, strategies are implemented and adapted to chronic care needs regionally, which creates the challenge of spreading successful efforts across regions. Second, each country struggles with how to ensure that clinical information follows patients seamlessly between care settings. Third, although each nation is pursuing telehealth solutions as a component of chronic care, the telehealth initiatives are usually stand-alone efforts that are not well integrated into other ICT solutions, such as electronic health records. Finally, countries have made progress in improving patients' access to their clinical data but have not fully succeeded in engaging patients to apply the data to improve care. These common themes suggest that although the four nations have different health care systems and ICT strategies, all of them face a similar set of challenges, creating an opportunity for cross-national learning.

摘要

全球各国都在投资健康信息和通信技术(ICT),将其作为改善慢性病患者护理的重要工具。我们对澳大利亚、加拿大、丹麦和美国这四个具有不同健康 ICT 战略的高收入国家进行了概况介绍,以描述它们如何利用 ICT 来改善慢性病护理。我们的目标是确定跨国学习的共同挑战和机遇。我们发现了四个关键主题。首先,尽管这四个国家都有一项采用健康 ICT 的国家战略,但该战略是在区域范围内实施和调整以满足慢性病护理的需求的,这就带来了在各区域间推广成功经验的挑战。其次,每个国家都在努力确保临床信息在患者的护理环境之间无缝传递。第三,尽管每个国家都在寻求远程医疗解决方案作为慢性病护理的一部分,但这些远程医疗举措通常是独立的努力,无法很好地融入电子健康记录等其他 ICT 解决方案中。最后,各国在改善患者获取其临床数据方面取得了进展,但尚未成功让患者利用这些数据来改善护理。这些共同的主题表明,尽管这四个国家拥有不同的医疗保健系统和 ICT 战略,但它们都面临着一系列相似的挑战,这为跨国学习创造了机会。

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