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部署后的互操作性:丹麦的持续挑战与区域策略

Interoperability after deployment: persistent challenges and regional strategies in Denmark.

作者信息

Kierkegaard Patrick

机构信息

Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.

出版信息

Int J Qual Health Care. 2015 Apr;27(2):147-53. doi: 10.1093/intqhc/mzv009. Epub 2015 Feb 19.

DOI:10.1093/intqhc/mzv009
PMID:25699549
Abstract

QUALITY PROBLEM OR ISSUE

The European Union has identified Denmark as one of the countries who have the potential to provide leadership and inspiration for other countries in eHealth implementation and adoption. However, Denmark has historically struggled to facilitate data exchange between their public hospitals' electronic health records (EHRs). Furthermore, state-led projects failed to adequately address the challenges of interoperability after deployment.

CHOICE OF SOLUTION

Changes in the organizational setup and division of responsibilities concerning the future of eHealth implementations in hospitals took place, which granted the Danish regions the full responsibility for all hospital systems, specifically the consolidation of EHRs to one system per region.

IMPLEMENTATION

The regions reduced the number of different EHRs to six systems by 2014. Additionally, the first version of the National Health Record was launched to provide health care practitioners with an overview of a patient's data stored in all EHRs across the regions and within the various health sectors.

EVALUATION

The governance of national eHealth implementation plays a crucial role in the development and diffusion of interoperable technologies. Changes in the organizational setup and redistribution of responsibilities between the Danish regions and the state play a pivotal role in producing viable and coherent solutions in a timely manner.

LESSONS LEARNED

Interoperability initiatives are best managed on a regional level or by the authorities responsible for the provision of local health care services. Cross-regional communication is essential during the initial phases of planning in order to set a common goal for countrywide harmonization, coherence and collaboration.

摘要

质量问题或议题

欧盟已认定丹麦是有潜力在电子健康实施和采用方面为其他国家提供引领和启发的国家之一。然而,丹麦长期以来一直在努力推动其公立医院电子健康记录(EHR)之间的数据交换。此外,国家主导的项目在部署后未能充分应对互操作性挑战。

解决方案选择

医院电子健康实施未来的组织架构和职责划分发生了变化,赋予丹麦各地区对所有医院系统的全面责任,特别是将电子健康记录整合到每个地区的一个系统中。

实施情况

到2014年,各地区将不同电子健康记录的数量减少到六个系统。此外,国家健康记录的首个版本发布,为医疗从业者提供患者在各地区所有电子健康记录以及不同卫生部门中存储的数据概况。

评估

国家电子健康实施的治理在可互操作技术的开发和传播中起着关键作用。丹麦各地区与国家之间组织架构的变化和职责的重新分配在及时产生可行且协调一致的解决方案方面发挥着关键作用。

经验教训

互操作性举措最好在地区层面或由负责提供当地医疗服务的当局进行管理。在规划的初始阶段,跨地区沟通至关重要,以便为全国范围的协调、连贯和协作设定共同目标。

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