Zelmer Jennifer, Ronchi Elettra, Hyppönen Hannele, Lupiáñez-Villanueva Francisco, Codagnone Cristiano, Nøhr Christian, Huebner Ursula, Fazzalari Anne, Adler-Milstein Julia
Azimuth Health Group, Toronto, Ontario, Canada.
School of Health Information Science, University of Victoria, Victoria, Canada.
J Am Med Inform Assoc. 2017 Mar 1;24(2):371-379. doi: 10.1093/jamia/ocw111.
To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning.
A prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking.
While electronic records are widely used to store and manage patient information at the point of care-all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%-patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist.
Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons.
While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries.
试行健康信息和通信技术(ICT)可用性及使用情况的基准衡量标准,以促进跨国学习。
经济合作与发展组织(经合组织)此前牵头开展了一项涉及30个国家的工作,选定并确定了基于功能的衡量标准,用于衡量电子健康记录、健康信息交换、个人健康记录和远程医疗的可用性及使用情况。在本次试点中,经合组织一个工作组汇总了38个国家在2012年至2015年期间使用新的和/或经调整的特定国家或跨国调查及其他来源得出的部分覆盖面广泛的衡量标准的结果。我们还综合了各国的经验教训,为未来的基准衡量提供参考。
虽然电子记录广泛用于在医疗点存储和管理患者信息——除2个试点国家外,所有国家均报告至少一半的初级保健医生使用电子记录;许多国家的使用率超过75%——但跨组织/机构的患者信息交换则不太常见。远程医疗和个人健康记录的可用性及使用情况也存在很大差异。
参与试点表明各国对跨国基准衡量感兴趣。利用迄今为止最具可比性的衡量标准,结果显示在所有领域的健康信息通信技术可用性及使用情况存在很大差异。该项目还确定了对未来比较很重要的方法学考量因素(例如,可能影响衡量的结构和卫生系统问题)。
虽然各国的卫生政策和重点不同,但许多国家旨在通过有效利用信息通信技术来增加医疗服务的可及性、提高质量和/或提升效率。通过识别差异并描述关键背景因素,基准衡量有可能促进跨国学习并加速各国的进步。