Walker Daniel M, Sieck Cynthia J, Menser Terri, Huerta Timothy R, Scheck McAlearney Ann
Department of Family Medicine, College of Medicine, Ohio State University, Columbus, OH, USA.
Department of Bioinformatics, College of Medicine, Ohio State University.
J Am Med Inform Assoc. 2017 Nov 1;24(6):1088-1094. doi: 10.1093/jamia/ocx043.
Given the strong push to empower patients and make them partners in their health care, we evaluated the current capability of hospitals to offer health information technology that facilitates patient engagement (PE).
Using an ontology mapping approach, items from the American Hospital Association Information Technology Supplement were mapped to defined levels and categories within the PE Framework. Points were assigned for each health information technology function based upon the level of engagement it encompassed to create a PE-information technology (PE-IT) score. Scores were divided into tertiles, and hospital characteristics were compared across tertiles. An ordered logit model was used to estimate the effect of characteristics on the adjusted odds of being in the highest tertile of PE-IT scores.
Thirty-six functions were mapped to specific levels and categories of the PE Framework, and adoption of each item ranged from 23.5 to 96.7%. Hospital characteristics associated with being in the highest tertile of PE-IT scores included medium and large bed size (relative to small), nonprofit (relative to government nonfederal), teaching hospital, system member, Midwest and South regions, and urban location.
Hospital adoption of PE-oriented technology remains varied, suggesting that hospitals are considering how technology can create partnerships with patients. However, PE functionalities that facilitate higher levels of engagement are lacking, suggesting room for improvement.
While hospitals have reached modest levels of adoption of PE technologies, consistent monitoring of this capacity can identify opportunities to use technology to facilitate engagement.
鉴于大力推动患者赋权并使其成为自身医疗保健的合作伙伴,我们评估了医院目前提供促进患者参与(PE)的健康信息技术的能力。
采用本体映射方法,将美国医院协会信息技术补充资料中的项目映射到PE框架内定义的级别和类别。根据每种健康信息技术功能所涵盖的参与程度为其分配分数,以创建PE信息技术(PE-IT)分数。分数分为三分位数,并对各三分位数的医院特征进行比较。使用有序logit模型估计各特征对处于PE-IT分数最高三分位数的调整后概率的影响。
36项功能被映射到PE框架的特定级别和类别,各项的采用率在23.5%至96.7%之间。与处于PE-IT分数最高三分位数相关的医院特征包括中等和大型床位规模(相对于小型)、非营利性(相对于政府非联邦)、教学医院、系统成员、中西部和南部地区以及城市位置。
医院对以PE为导向的技术的采用情况仍然各不相同,这表明医院正在考虑技术如何与患者建立伙伴关系。然而,缺乏促进更高参与水平的PE功能,这表明仍有改进空间。
虽然医院在PE技术的采用方面已达到适度水平,但持续监测这一能力可以发现利用技术促进参与的机会。