Balio Casey P, Apathy Nate C, Danek Robin L
Indiana University Richard M. Fairbanks School of Public Health, US.
Regenstrief Institute, US.
EGEMS (Wash DC). 2019 Jul 8;7(1):24. doi: 10.5334/egems.261.
Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals.
We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research.
We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study.
Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results.
In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations.
自 accountable care organizations（ACOs，可问责医疗组织）成立以来，许多人都认识到 ACOs 与健康信息技术（IT）在实现质量和成本目标方面可能存在协同作用。
我们对文献进行了系统综述，以描述在健康 IT 与 ACOs 交叉领域开展了哪些研究，并确定未来研究的方向。
我们通过 PubMed 搜索并随后进行滚雪球式参考文献审查，确定了讨论健康 IT 使用情况的实证研究。从每项研究中提取健康 IT 的类型、健康 IT 在研究中的纳入方式、理论的使用、研究人群和研究结果。
我们的搜索产生了 32 项描述健康 IT 与 ACOs 交叉领域的研究，主要形式为电子健康记录和健康信息交换。研究按目的分为三个类别；那些将健康 IT 视为 ACO 参与因素的研究、当前 ACOs 使用健康 IT 的研究，以及将 ACO 绩效视为健康 IT 能力函数的研究。尽管大多数研究发现健康 IT 与 ACO 参与之间存在正相关，但从健康 IT 能力方面探讨 ACOs 绩效的研究结果则更为复杂。
为了更好地理解健康 IT 与 ACO 绩效之间这种新出现的关系，我们建议未来的研究应考虑更多的准实验研究、理论的使用，并整合 ACO 成员组织之间的健康、质量、成本和健康 IT 使用数据。
