Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, Indiana, USA.
Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA.
J Am Med Inform Assoc. 2019 Aug 1;26(8-9):891-894. doi: 10.1093/jamia/ocz052.
The Indian Health Service provides care to remote and under-resourced communities in the United States. American Indian/Alaska Native patients have some of the highest morbidity and mortality among any ethnic group in the United States. Starting in the 1980s, the IHS implemented the Resource and Patient Management System health information technology (HIT) platform to improve efficiency and quality to address these disparities. The IHS is currently assessing the Resource and Patient Management System to ensure that changing health information needs are met. HIT assessments have traditionally focused on cost, reimbursement opportunities, infrastructure, required or desired functionality, and the ability to meet provider needs. Little information exists on frameworks that assess HIT legacy systems to determine solutions for an integrated rural healthcare system whose end goal is health equity. This search for a next-generation HIT solution for a historically underserved population presents a unique opportunity to envision and redefine HIT that supports health equity as its core mission.
美国印第安人事务局为美国偏远和资源匮乏的社区提供医疗服务。美国印第安人/阿拉斯加原住民患者的发病率和死亡率在所有种族群体中是最高的。从 20 世纪 80 年代开始,印第安人事务局实施了资源和患者管理系统卫生信息技术 (HIT) 平台,以提高效率和质量,解决这些差距。印第安人事务局目前正在评估资源和患者管理系统,以确保满足不断变化的健康信息需求。HIT 评估传统上侧重于成本、报销机会、基础设施、所需或期望的功能以及满足提供者需求的能力。关于评估 HIT 遗留系统以确定解决方案的框架的信息很少,这些解决方案是为其最终目标是实现健康公平的综合农村医疗保健系统而制定的。为历史上服务不足的人群寻找下一代 HIT 解决方案,为设想和重新定义以实现健康公平为核心使命的 HIT 提供了一个独特的机会。