McCarthy Douglas B, Propp Karen, Cohen Alexander, Sabharwal Raj, Schachter Abigail A, Rein Alison L
Commonwealth Fund.
Institute for Healthcare Improvement.
EGEMS (Wash DC). 2014 May 5;2(1):1060. doi: 10.13063/2327-9214.1060. eCollection 2014.
As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions.
随着医疗服务提供者采用并“有效利用”健康信息技术（健康IT），社区和医疗服务提供系统必须建立基础设施，以促进医疗服务提供者与众多其他在支持健康和护理方面发挥作用的利益相关者之间的健康信息交换（HIE）。通过促进医疗服务提供者之间更好的沟通与协调，HIE有潜力改善临床决策和护理的连续性，同时减少不必要的服务使用。当作为医疗服务提供系统和支付改革更广泛战略的一部分实施时，HIE能力还可以支持使用人群健康管理、患者参与护理以及持续学习与改进所需的分析工具。参与为期三年的联邦灯塔社区计划的七个社区的不同经历，为影响交换基础设施技术架构的因素及其在支持改善护理、降低成本和促进人口健康方面的作用提供了实际见解。这些案例研究还记录了社区面临的挑战，例如协调数据标准解释差异所需的大量时间和资源。研究结果表明，他们制定基于社区的HIE战略的进展，虽然受当地需求和目标驱动，但也受到更广泛的法律、政策和市场条件的影响。
