Clarke Jonathan M, Warren Leigh R, Arora Sonal, Barahona Mauricio, Darzi Ara W
1NIHR Patient Safety Translational Research Centre, Imperial College London, London, W2 1NY UK.
2EPSRC Centre for Mathematics of Precision Healthcare, Imperial College London, London, SW7 2AZ UK.
NPJ Digit Med. 2018 Dec 10;1:65. doi: 10.1038/s41746-018-0072-y. eCollection 2018.
Effective sharing of clinical information between care providers is a critical component of a safe, efficient health system. National data-sharing systems may be costly, politically contentious and do not reflect local patterns of care delivery. This study examines hospital attendances in England from 2013 to 2015 to identify instances of patient sharing between hospitals. Of 19.6 million patients receiving care from 155 hospital care providers, 130 million presentations were identified. On 14.7 million occasions (12%), patients attended a different hospital to the one they attended on their previous interaction. A network of hospitals was constructed based on the frequency of patient sharing between hospitals which was partitioned using the Louvain algorithm into ten distinct data-sharing communities, improving the continuity of data sharing in such instances from 0 to 65-95%. Locally implemented data-sharing communities of hospitals may achieve effective accessibility of clinical information without a large-scale national interoperable information system.
医疗服务提供者之间有效地共享临床信息是安全、高效的卫生系统的关键组成部分。国家数据共享系统可能成本高昂，在政治上存在争议，且无法反映当地的医疗服务模式。本研究调查了2013年至2015年英格兰的医院就诊情况，以确定医院之间患者共享的实例。在155家医院医疗服务提供者的1960万名接受治疗的患者中，共识别出1.3亿次就诊。在1470万次（12%）的情况下，患者就诊的医院与他们上一次就诊的医院不同。基于医院之间患者共享的频率构建了一个医院网络，使用Louvain算法将其划分为十个不同的数据共享社区，将此类情况下数据共享的连续性从0提高到65%-95%。在没有大规模国家可互操作信息系统的情况下，当地实施的医院数据共享社区可能实现临床信息的有效获取。
