加拿大对 COVID-19 的紧急应对：危机管理中的电子健康平台开发与实施。
Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management.
机构信息
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
出版信息
JMIR Public Health Surveill. 2020 May 15;6(2):e18995. doi: 10.2196/18995.
BACKGROUND
Public health emergencies like epidemics put enormous pressure on health care systems while revealing deep structural and functional problems in the organization of care. The current coronavirus disease (COVID-19) pandemic illustrates this at a global level. The sudden increased demand on delivery systems puts unique pressures on pre-established care pathways. These extraordinary times require efficient tools for smart governance and resource allocation.
OBJECTIVE
The aim of this study is to develop an innovative web-based solution addressing the seemingly insurmountable challenges of triaging, monitoring, and delivering nonhospital services unleashed by the COVID-19 pandemic.
METHODS
An adaptable crisis management digital platform was envisioned and designed with the goal of improving the system's response on the basis of the literature; an existing shared health record platform; and discussions between health care providers, decision makers, academia, and the private sector in response to the COVID 19 epidemic.
RESULTS
The Crisis Management Platform was developed and offered to health authorities in Ontario on a nonprofit basis. It has the capability to dramatically streamline patient intake, triage, monitoring, referral, and delivery of nonhospital services. It decentralizes the provision of services (by moving them online) and centralizes data gathering and analysis, maximizing the use of existing human resources, facilitating evidence-based decision making, and minimizing the risk to both users and providers. It has unlimited scale-up possibilities (only constrained by human health risk resource availability) with minimal marginal cost. Similar web-based solutions have the potential to fill an urgent gap in resource allocation, becoming a unique asset for health systems governance and management during critical times. They highlight the potential effectiveness of web-based solutions if built on an outcome-driven architecture.
CONCLUSIONS
Data and web-based approaches in response to a public health crisis are key to evidence-driven oversight and management of public health emergencies.
背景
流行病等公共卫生紧急情况给医疗保健系统带来了巨大压力，同时也暴露出医疗服务组织中存在的深层次结构性和功能性问题。当前的冠状病毒病（COVID-19）大流行在全球范围内说明了这一点。交付系统突然增加的需求给预先建立的护理途径带来了独特的压力。这些特殊时期需要有效的工具来实现智能治理和资源分配。
目的
本研究旨在开发一种创新的基于网络的解决方案，以应对 COVID-19 大流行带来的分诊、监测和提供非医院服务的看似无法克服的挑战。
方法
设想并设计了一个适应性强的危机管理数字平台，旨在根据文献；现有的共享健康记录平台；以及医疗保健提供者、决策者、学术界和私营部门之间的讨论，针对 COVID-19 疫情改进系统的响应。
结果
危机管理平台是在非营利的基础上为安大略省的卫生当局开发和提供的。它具有显著简化患者入院、分诊、监测、转诊和非医院服务提供的能力。它将服务的提供去中心化（通过将其转移到线上）并集中数据收集和分析，最大限度地利用现有人力资源，促进基于证据的决策，并最大程度地降低用户和提供者的风险。它具有无限的扩展可能性（仅受人类健康风险资源可用性的限制），边际成本最小。类似的基于网络的解决方案有可能填补资源分配方面的紧急空白，成为关键时期卫生系统治理和管理的独特资产。它们突出了基于结果驱动架构构建的基于网络的解决方案的潜在有效性。
结论
针对公共卫生危机的数据和基于网络的方法是进行循证监督和管理公共卫生紧急情况的关键。
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