A Jay Holmgren (
Vaishali Patel is a senior advisor in the Office of Planning, Evaluation, and Analysis, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, in Washington, D.C.
Health Aff (Millwood). 2017 Oct 1;36(10):1820-1827. doi: 10.1377/hlthaff.2017.0546.
Achieving an interoperable health care system remains a top US policy priority. Despite substantial efforts to encourage interoperability, the first set of national data in 2014 suggested that hospitals' engagement levels were low. With 2015 data now available, we examined the first national trends in engagement in four domains of interoperability: finding, sending, receiving, and integrating electronic patient information from outside providers. We found small gains, with 29.7 percent of hospitals engaging in all four domains in 2015 compared to 24.5 percent in 2014. The two domains with the most progress were sending (with an increase of 8.1 percentage points) and receiving (an increase of 8.4 percentage points) information, while there was no change in integrating systems. Hospitals' use for patient care of data from outside providers was low, with only 18.7 percent of hospitals reporting that they "often" used these data. Our results reveal that hospitals' progress toward interoperability is slow and that progress is focused on moving information between hospitals, not on ensuring usability of information in clinical decisions.
实现可互操作的医疗保健系统仍然是美国的首要政策重点。尽管为鼓励互操作性做出了大量努力，但 2014 年的第一组国家数据表明，医院的参与度较低。随着 2015 年数据的公布，我们研究了在四个互操作性领域的参与的第一个全国性趋势：查找、发送、接收和整合来自外部提供商的电子患者信息。我们发现了一些小的进展，与 2014 年相比，2015 年有 29.7%的医院在所有四个领域都有参与。在发送（增加 8.1 个百分点）和接收（增加 8.4 个百分点）信息方面取得了最大的进展，而系统整合方面没有变化。医院对来自外部提供商的数据在患者护理中的使用情况较低，只有 18.7%的医院报告说他们“经常”使用这些数据。我们的研究结果表明，医院在实现互操作性方面进展缓慢，而且进展主要集中在医院之间传递信息，而不是确保信息在临床决策中的可用性。
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