Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.
Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.
复制标题
美国社区健康信息组织活动的地理：对健康信息交换有效性的影响。
DOI：
10.1097/hmr.0000000000000103
复制
发表时间：
2017
影响因子：
2.5
通讯作者：
Vest,JoshuaR
中科院分区：
文献类型：
--
作者：
Vest,JoshuaR
背景：美国已投资近10亿美元建立社区卫生信息组织（HIOs），以促进卫生信息交流。社区HIO为不同地理区域内的医疗保健组织提供交流服务。虽然地理是一个关键的组织原则，为社区HIOs，目前还不清楚，如果地理是一个有效的组织方法或什么样的挑战是由一个基于地理的方法创建的健康信息exchanges.Purpose：本研究介绍了报告的社区HIO覆盖范围在美国的程度，并探讨HIO服务领域的重叠和差距的实际和政策影响。此外，由于自我报告的服务领域可能无法准确地反映HIOs活动的真实程度，本研究映射的实际市场包括在每个HIO.Methodology：库存的业务社区HIOs，包括自我报告的地理市场和参与组织的脸验证使用众包的方法。参与医院的各个医疗保健市场的汇总提供了每个社区HIO服务的总地理市场。地图和覆盖分析，使用地理信息系统的方法描述了社区HIO活动在美国的程度。调查结果：证据表明，社区HIO可能是低效的分布。美国部分地区有多个重叠的HIO，而其他地区则没有任何提供健康信息交换服务的HIO。在多个社区HIOs服务的市场，45%的医院参与者只有一个HIO.Practice的影响：目前的地理社区HIO活动不提供全面的病人信息提供商，也没有社区范围内的公共卫生机构的信息。社区卫生组织的自我报告和市场地理之间的不协调引起了人们对卫生信息交流的潜在有效性的关注，说明了地理作为一种组织原则的局限性，并表明了那些领导和与社区卫生组织合作的人所面临的业务挑战。
Background:The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange.Purpose:This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO.Methodology:An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals’ individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States.Findings:Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO.Practice implications:The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as an organizing principle, and indicates operational challenges facing those leading and working with community HIOs.