Harris Daniel R, Harper Tamela J, Henderson Darren W, Henry Keith W, Talbert Jeffery C
Center for Clinical and Translational Sciences, University of Kentucky, Lexington, Kentucky 40506.
IEEE EMBS Int Conf Biomed Health Inform. 2016 Feb;2016:513-516. doi: 10.1109/BHI.2016.7455947. Epub 2016 Apr 21.
We discuss informatics-based challenges of constructing large-scale collaborative networks for healthcare research and analysis from rural community health centers. These types of networks provide data access and analytic insights across multiple heterogeneous health centers for both healthcare professionals and biomedical researchers. Challenges fall into three general categories: data access, data integration, and technical infrastructure. Data access issues arise in balancing patient privacy, security, and utility; data integration issues persist from each site independently operating its desired electronic medical record; technical infrastructure challenges include creating an analysis and reporting hub capable of scaling across a large collaborative network. Other challenges, such as the difficulty of site recruitment, are important to discuss, but cannot be solved directly through informatics alone. We discuss these challenges and their potential solutions in the context of our implementation of the Kentucky Diabetes and Obesity Collaborative (KDOC). KDOC is a network of Federally-Qualified Community Health Centers (FQHCs) that established a collaborative infrastructure for research and analysis of obesity and diabetes in rural and under-served communities.
我们讨论了基于信息学的挑战,这些挑战涉及为农村社区卫生中心构建大规模医疗保健研究与分析协作网络。这类网络为医疗保健专业人员和生物医学研究人员提供了跨多个异构卫生中心的数据访问和分析见解。挑战大致可分为三类:数据访问、数据集成和技术基础设施。数据访问问题产生于平衡患者隐私、安全性和实用性;数据集成问题源于每个站点独立运行其所需的电子病历;技术基础设施挑战包括创建一个能够在大型协作网络中扩展的分析和报告中心。其他挑战,如站点招募的困难,虽然值得讨论,但无法仅通过信息学直接解决。我们在肯塔基糖尿病与肥胖协作组织(KDOC)的实施背景下讨论这些挑战及其潜在解决方案。KDOC是一个由联邦合格社区卫生中心(FQHC)组成的网络,该网络为农村和服务不足社区的肥胖症和糖尿病研究与分析建立了协作基础设施。