Insights From Advanced Analytics At The Veterans Health Administration
Insights From Advanced Analytics At The Veterans Health Administration
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DOI：
10.1377/hlthaff.2014.0054
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发表时间：
2014-07-01
期刊：
影响因子：
9.7
通讯作者：
Graham, Gail L.
中科院分区：
文献类型：
--
作者：
Fihn, Stephan D.;Francis, Joseph;Graham, Gail L.
医疗保健在高级分析的使用方面落后于其他行业。退伍军人健康管理局 (VHA) 拥有三十年的经验，通过当地开发的使用通用电子健康记录的信息系统收集其在全国范围内服务的退伍军人的数据。 2006 年，VHA 开始建立其企业数据仓库，这是一个从 VHA 的国家卫生系统汇总的患者级数据的存储库。本文对 VHA 向“大数据”的演变进行了高度概述，“大数据”的定义是将先进工具和方法应用于大型、复杂且快速变化的数据集的快速演变。它说明了先进的分析如何支持 VHA 的活动，这些活动包括从个体患者的常规临床护理（例如，监测药物管理和预测不良结果的风险）到评估系统范围内的计划，以将以患者为中心的医疗之家的原则带给所有退伍军人。本文还分享了在此过程中出现的一些挑战、担忧、见解和应对措施，例如需要将新功能顺利集成到临床工作流程中。虽然 VHA 在很多方面都是独一无二的，但它的经验可能会为全国其他医疗保健系统涉足大数据领域提供重要的见解。
Health care has lagged behind other industries in its use of advanced analytics. The Veterans Health Administration (VHA) has three decades of experience collecting data about the veterans it serves nationwide through locally developed information systems that use a common electronic health record. In 2006 the VHA began to build its Corporate Data Warehouse, a repository for patient-level data aggregated from across the VHA's national health system. This article provides a high-level overview of the VHA's evolution toward "big data," defined as the rapid evolution of applying advanced tools and approaches to large, complex, and rapidly changing data sets. It illustrates how advanced analysis is already supporting the VHA's activities, which range from routine clinical care of individual patients-for example, monitoring medication administration and predicting risk of adverse outcomes-to evaluating a systemwide initiative to bring the principles of the patient-centered medical home to all veterans. The article also shares some of the challenges, concerns, insights, and responses that have emerged along the way, such as the need to smoothly integrate new functions into clinical workflow. While the VHA is unique in many ways, its experience may offer important insights for other health care systems nationwide as they venture into the realm of big data.