Hughes Lauren S, Phillips Robert L, DeVoe Jennifer E, Bazemore Andrew W
From the Pennsylvania Department of Health, Harrisburg (LSH); the American Board of Family Medicine, Lexington, KY (RLP); OCHIN, Inc., Portland, OR (JED); Department of Family Medicine, Oregon Health & Science University, Portland (JED); and The Robert Graham Center, Washington, DC (AWB).
J Am Board Fam Med. 2016 May-Jun;29(3):419-22. doi: 10.3122/jabfm.2016.03.150172.
In 2014 both the Institute of Medicine and the National Quality Forum recommended the inclusion of social determinants of health data in electronic health records (EHRs). Both entities primarily focus on collecting socioeconomic and health behavior data directly from individual patients. The burden of reliably, accurately, and consistently collecting such information is substantial, and it may take several years before a primary care team has actionable data available in its EHR. A more reliable and less burdensome approach to integrating clinical and social determinant data exists and is technologically feasible now. Community vital signs-aggregated community-level information about the neighborhoods in which our patients live, learn, work, and play-convey contextual social deprivation and associated chronic disease risks based on where patients live. Given widespread access to "big data" and geospatial technologies, community vital signs can be created by linking aggregated population health data with patient addresses in EHRs. These linked data, once imported into EHRs, are a readily available resource to help primary care practices understand the context in which their patients reside and achieve important health goals at the patient, population, and policy levels.
2014年，美国医学研究所和国家质量论坛都建议将健康数据的社会决定因素纳入电子健康记录（EHR）。这两个机构主要专注于直接从个体患者那里收集社会经济和健康行为数据。可靠、准确且持续地收集此类信息的负担很重，而且基层医疗团队可能需要数年时间才能在其电子健康记录中获得可用于行动的数据。现在存在一种更可靠且负担较小的整合临床和社会决定因素数据的方法，并且在技术上是可行的。社区生命体征——汇总了有关我们患者生活、学习、工作和娱乐所在社区的社区层面信息——基于患者居住的地点传达背景性社会剥夺和相关的慢性病风险。鉴于广泛获取“大数据”和地理空间技术，可以通过将汇总的人口健康数据与电子健康记录中的患者地址相链接来创建社区生命体征。这些链接数据一旦导入电子健康记录，就是一种现成的资源，可帮助基层医疗机构了解其患者居住的环境，并在患者、人群和政策层面实现重要的健康目标。
