Des Jardins Terrisca R
Independent Consultant, formerly of Southeast Michigan Beacon Community.
EGEMS (Wash DC). 2014 Jul 21;2(3):1068. doi: 10.13063/2327-9214.1068. eCollection 2014.
Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals.
鉴于《平价医疗法案》下 accountable care organizations(ACOs)的出现以及其他类似的关注人群健康的倡议,基于社区的健康信息交换(HIEs)以及整合和存储数据的努力正在不断增加。密歇根东南部灯塔社区(SEMBC)可作为一个案例研究,从中汲取经验教训,了解在治理和利益相关者参与方面所面临的挑战及相应的解决办法。SEMBC 案例研究采用了既定的数据仓库治理框架来识别和解释必要的治理和利益相关者参与要素,特别是与全社区数据共享以及数据仓库或存储库相关的要素。通过 SEMBC 的经验,或许最大的教训是基于社区的工作很艰难。它需要大量的社区领导力、协作和资源。SEMBC 发现,为了在利益相关者组织之间建立所需的关系和信任,需要不断重新审视和培育组织结构及指导原则。SEMBC 还发现,在三年试点期开始时及整个期间,风险和风险缓解策略既带来了挑战,也带来了机遇。全国其他开展类似努力的社区需要对社区数据共享基础设施以及随之而来且必要的治理和利益相关者参与基本要素抱有现实的期望。