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建立社区卫生中心的能力,以通过开发灵活的 COVID-19 公共卫生登记处克服数据挑战:一项多州质量改进努力。

Building capacity of community health centers to overcome data challenges with the development of an agile COVID-19 public health registry: a multistate quality improvement effort.

机构信息

Centers for Disease Control and Prevention COVID-19 Response, Health Systems and Worker Safety Task Force, Atlanta, Georgia, USA.

National Association of Community Health Centers, Department of Clinical Affairs, Bethesda, Maryland, USA.

出版信息

J Am Med Inform Assoc. 2021 Dec 28;29(1):80-88. doi: 10.1093/jamia/ocab233.

Abstract

OBJECTIVE

During the coronavirus disease 2019 (COVID-19) pandemic, federally qualified health centers rapidly mobilized to provide SARS-CoV-2 testing, COVID-19 care, and vaccination to populations at increased risk for COVID-19 morbidity and mortality. We describe the development of a reusable public health data analytics system for reuse of clinical data to evaluate the health burden, disparities, and impact of COVID-19 on populations served by health centers.

MATERIALS AND METHODS

The Multistate Data Strategy engaged project partners to assess public health readiness and COVID-19 data challenges. An infrastructure for data capture and sharing procedures between health centers and public health agencies was developed to support existing capabilities and data capacities to respond to the pandemic.

RESULTS

Between August 2020 and March 2021, project partners evaluated their data capture and sharing capabilities and reported challenges and preliminary data. Major interoperability challenges included poorly aligned federal, state, and local reporting requirements, lack of unique patient identifiers, lack of access to pharmacy, claims and laboratory data, missing data, and proprietary data standards and extraction methods.

DISCUSSION

Efforts to access and align project partners' existing health systems data infrastructure in the context of the pandemic highlighted complex interoperability challenges. These challenges remain significant barriers to real-time data analytics and efforts to improve health outcomes and mitigate inequities through data-driven responses.

CONCLUSION

The reusable public health data analytics system created in the Multistate Data Strategy can be adapted and scaled for other health center networks to facilitate data aggregation and dashboards for public health, organizational planning, and quality improvement and can inform local, state, and national COVID-19 response efforts.

摘要

目的

在 2019 年冠状病毒病(COVID-19)大流行期间,联邦合格的健康中心迅速动员起来,为罹患 COVID-19 发病率和死亡率风险增加的人群提供 SARS-CoV-2 检测、COVID-19 护理和疫苗接种。我们描述了一个可重复使用的公共卫生数据分析系统的开发,用于重新使用临床数据来评估健康中心服务人群的健康负担、差异和 COVID-19 的影响。

材料和方法

多州数据策略使项目合作伙伴参与进来,以评估公共卫生准备情况和 COVID-19 数据挑战。开发了一种用于健康中心和公共卫生机构之间数据捕获和共享程序的基础设施,以支持现有能力和数据能力,以应对大流行。

结果

在 2020 年 8 月至 2021 年 3 月期间,项目合作伙伴评估了他们的数据捕获和共享能力,并报告了挑战和初步数据。主要的互操作性挑战包括联邦、州和地方报告要求不一致、缺乏唯一的患者标识符、无法访问药房、索赔和实验室数据、数据缺失以及专有的数据标准和提取方法。

讨论

在大流行背景下,努力访问和调整项目合作伙伴现有的卫生系统数据基础设施,突出了复杂的互操作性挑战。这些挑战仍然是实时数据分析和通过数据驱动的响应改善健康结果和减轻不平等的重大障碍。

结论

在多州数据策略中创建的可重复使用的公共卫生数据分析系统可以适应和扩展到其他健康中心网络,以促进公共卫生、组织规划和质量改进的数据聚合和仪表板,并为地方、州和国家 COVID-19 应对工作提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7907/8714277/b45bf4460045/ocab233f1.jpg

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