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用于人群健康的全州范围卫生信息技术基础设施:为马里兰州的全支付方全球预算构建社区范围的电子平台。

A State-wide Health IT Infrastructure for Population Health: Building a Community-wide Electronic Platform for Maryland's All-Payer Global Budget.

作者信息

Hatef Elham, Kharrazi Hadi, VanBaak Ed, Falcone Marc, Ferris Lindsey, Mertz Kory, Perman Chad, Bauman Alice, Lasser Elyse C, Weiner Jonathan P

机构信息

Center for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Chesapeake Regional Information System for our Patients (CRISP), Columbia, Maryland.

出版信息

Online J Public Health Inform. 2017 Dec 31;9(3):e195. doi: 10.5210/ojphi.v9i3.8129. eCollection 2017.

Abstract

Maryland Department of Health (MDH) has been preparing for alignment of its population health initiatives with Maryland's unique All-Payer hospital global budget program. In order to operationalize population health initiatives, it is required to identify a starter set of measures addressing community level health interventions and to collect interoperable data for those measures. The broad adoption of electronic health records (EHRs) with ongoing data collection on almost all patients in the state, combined with hospital participation in health information exchange (HIE) initiatives, provides an unprecedented opportunity for near real-time assessment of the health of the communities. MDH's EHR-based monitoring complements, and perhaps replaces, ad-hoc assessments based on limited surveys, billing, and other administrative data. This article explores the potential expansion of health IT capacity as a method to improve population health across Maryland. First, we propose a progression plan for four selected community-wide population health measures: body mass index, blood pressure, smoking status, and falls-related injuries. We then present an assessment of the current and near real-time availability of digital data in Maryland including the geographic granularity on which each measure can be assessed statewide. Finally, we provide general recommendations to improve interoperable data collection for selected measures over time via the Maryland HIE. This paper is intended to serve as a high level guiding framework for communities across the US that are undergoing healthcare transformation toward integrated models of care using universal interoperable EHRs.

摘要

马里兰州卫生部(MDH)一直在为使其人口健康计划与马里兰州独特的全支付方医院全球预算计划保持一致做准备。为了实施人口健康计划,需要确定一套初步的措施,以解决社区层面的健康干预问题,并为这些措施收集可互操作的数据。电子健康记录(EHRs)在该州几乎所有患者中得到广泛采用,并持续进行数据收集,再加上医院参与健康信息交换(HIE)计划,为近乎实时评估社区健康状况提供了前所未有的机会。MDH基于EHR的监测补充了,甚至可能取代了基于有限调查、计费和其他行政数据的临时评估。本文探讨了扩大健康信息技术能力作为改善马里兰州全体居民健康状况的一种方法的潜力。首先,我们为四项选定的全社区人口健康指标提出了一个推进计划:体重指数、血压、吸烟状况和与跌倒相关的伤害。然后,我们对马里兰州数字数据的当前和近乎实时的可用性进行了评估,包括可以在全州范围内评估每项指标的地理粒度。最后,我们提出了一般性建议,以便随着时间的推移,通过马里兰州健康信息交换平台(Maryland HIE)改进选定指标的可互操作数据收集。本文旨在为美国各地正在向使用通用可互操作电子健康记录的综合护理模式转变的社区提供一个高层次的指导框架。

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