Angier Heather, Jacobs Elizabeth A, Huguet Nathalie, Likumahuwa-Ackman Sonja, Robert Stephanie, DeVoe Jennifer E
Oregon Health & Science University, Portland, Oregon, USA.
University of Texas at Austin, Dell Medical School, Austin, Texas, USA.
Fam Med Community Health. 2018 Dec 6;7(1):e000028. doi: 10.1136/fmch-2018-000028. eCollection 2019.
Community-level factors have significant impacts on health. There is renewed enthusiasm for integrating these data with electronic health record (EHR) data for use in primary care to improve health equity in the USA. Thus, it is valuable to reflect on what has been published to date. Specifically, we comment on: (1) recommendations about combining community-level factors in EHRs for use in primary care; (2) examples of how these data have been combined and used; and (3) the impact of using combined data on healthcare, patient health and health equity. We found publications discussing the potential of combined data to inform clinical care, target interventions, track population health and spark community partnerships with the goal of reducing health disparities and improving health equity. Although there is great enthusiasm and potential for using these data to inform primary care, there is little evidence of improved healthcare, patient health or health equity.
社区层面的因素对健康有重大影响。人们重新燃起了将这些数据与电子健康记录（EHR）数据整合用于初级保健以改善美国健康公平性的热情。因此，反思迄今为止已发表的内容很有价值。具体而言，我们评论：（1）关于在初级保健中在电子健康记录中结合社区层面因素的建议；（2）这些数据如何被结合和使用的示例；以及（3）使用合并数据对医疗保健、患者健康和健康公平性的影响。我们发现有出版物讨论了合并数据在为临床护理提供信息、确定干预目标、跟踪人群健康以及促进社区伙伴关系以减少健康差距和改善健康公平性方面的潜力。尽管使用这些数据为初级保健提供信息有很大的热情和潜力，但几乎没有证据表明医疗保健、患者健康或健康公平性得到了改善。
