Distributed Health Data Networks A Practical and Preferred Approach to Multi-Institutional Evaluations of Comparative Effectiveness, Safety, and Quality of Care
Distributed Health Data Networks A Practical and Preferred Approach to Multi-Institutional Evaluations of Comparative Effectiveness, Safety, and Quality of Care
复制标题
DOI：
10.1097/mlr.0b013e3181d9919f
复制
发表时间：
2010-06-01
期刊：
影响因子：
3
通讯作者：
Platt, Richard
中科院分区：
文献类型：
--
作者：
Brown, Jeffrey S.;Holmes, John H.;Platt, Richard
背景资料：比较有效性研究、医疗产品安全性评价和质量测量将需要能够使用多个组织持有的电子健康数据。对于是否为此目的创建区域或国家联合（例如，“所有付款人”）数据库，或将大多数受保护的健康信息和专有数据保留在原始数据持有者手中的分布式数据网络，目前尚未达成共识。目标：展示分布式研究网络的功能，支持研究需求并解决数据持有者对参与的担忧。关键的设计功能包括对数据使用的强有力的本地控制和集中的基于网络的查询界面。研究设计：我们实施了一个试点分布式研究网络和评估的设计考虑因素，研究的效用，并接受数据持有人的方法菜单驱动的查询。我们开发并测试了一个中央的、基于网络的界面，并支持网络软件。评估的具体功能包括查询的形成和分布，查询执行和审查，并聚集results.Results：这个试点成功地评估了时间趋势的药物使用和诊断在5个不同的网站，展示了一些使用分布式研究网络的可能性。试点项目显示了该设计的潜在效用，解决了用户和数据持有者的主要关切。没有严重的障碍，将阻止一个功能齐全，可扩展的network.Conclusions的发展：分布式网络能够解决几乎所有的预期用途的常规收集的电子医疗保健数据。分布式网络将消除对集中式数据库的需求，从而避免许多障碍。
Background: Comparative effectiveness research, medical product safety evaluation, and quality measurement will require the ability to use electronic health data held by multiple organizations. There is no consensus about whether to create regional or national combined (eg, "all payer") databases for these purposes, or distributed data networks that leave most Protected Health Information and proprietary data in the possession of the original data holders.Objectives: Demonstrate functions of a distributed research network that supports research needs and also address data holders concerns about participation. Key design functions included strong local control of data uses and a centralized web-based querying interface. Research Design: We implemented a pilot distributed research network and evaluated the design considerations, utility for research, and the acceptability to data holders of methods for menu-driven querying. We developed and tested a central, web-based interface with supporting network software. Specific functions assessed include query formation and distribution, query execution and review, and aggregation of results.Results: This pilot successfully evaluated temporal trends in medication use and diagnoses at 5 separate sites, demonstrating some of the possibilities of using a distributed research network. The pilot demonstrated the potential utility of the design, which addressed the major concerns of both users and data holders. No serious obstacles were identified that would prevent development of a fully functional, scalable network.Conclusions: Distributed networks are capable of addressing nearly all anticipated uses of routinely collected electronic healthcare data. Distributed networks would obviate the need for centralized databases, thus avoiding numerous obstacles.