Personally Controlled Sharing of Medical Images in the Rural and Urban Southeast

东南农村和城市医疗图像的个人控制共享

• 批准号: 7938662
• 负责人: John Jeffrey Carr
• 金额: $ 106.68万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938662
• 关键词: Address; Affinity; Archives; Clinical; Communities; Data; Data Security; Diagnosis; Electronic Health Record; Electronics; Grant; Health; Health Care Costs; Health Personnel; Health Status; Healthcare; Healthcare Power of Attorney; Healthcare Systems; Hybrids; Image; Individual; Location; Measures; Mediation; Medical; Medical Imaging; Modeling; Morbidity - disease rate; Names; Nature; Patients; Personal Health Records; Persons; Policies; Premature Mortality; Provider; Registries; Research; Research Infrastructure; Resources; Rural; Secondary to; Secure; Security; Services; Solutions; Stream; System; Technology; Testing; Time; Underserved Population; Work; base; cost; data sharing; design; empowered; experience; health information technology; health record; image archival system; improved; innovation; interoperability; novel strategies; prototype; public health relevance; repository; socioeconomics

DESCRIPTION (provided by applicant): Medical imaging is a critical and expensive component of health care with a cost of $100 billion or $350 per person per year. Health information technology (HIT) is proposed as a means to reduce costs and improve health through more efficient and coordinated services. The gains will be greatest in communities with unmet health needs; however, these communities present unique HIT challenges. We propose a demonstration project of clinical imaging data sharing in the rural and urban southeastern U.S. Personal health record (PHR) approaches are promising as an effective framework for sharing medical information; however, imaging poses unique challenges. Existing approaches include a centralized repository, which if expanded to medical imaging would require substantial archive and network infrastructure. These resources do not currently exist in most communities, especially rural and underserved communities, presenting logistical and financial barriers. We propose a new approach that we have named "Personally Controlled Access key REgistry" or PCARE. PCARE addresses the fundamental problem of moving large amounts of imaging data from imaging providers to a centralized archive. In the PCARE paradigm the imaging data remains at the performing imaging provider as the primary archive until needed by an authorized health care provider. In place of the PHR archive, the PCARE is a central repository of secure encrypted electronic "keys". These electronic "keys" are under the direct control of the patient or authorized representative. The patient can grant and revoke access to providers to their data irrespective of the physical location of the patient, images or provider. The transfer of the imaging data from the performing facility directly to any provider of the patient's choosing can occur in a selective and timely manner. This innovation takes full advantage of the patient controlled nature of the PHR paradigm and overcomes many of the pitfalls of a centralized health record approach in regards to imaging. The broad, long-term objective is to improve health care through improved sharing of medical imaging data. Effective sharing can improve diagnosis, reduce unnecessary testing and contain costs. The specific aims are: (1) to analyze the needs, capabilities, and obstacles for medical image sharing across the spectrum of patients, providers, and medical facilities in rural and urban Southeastern U.S. as a national model for underserved communities. (2) to develop a patient controlled platform for medical image sharing using PCARE, designed to integrate seamlessly with electronic health records of participating providers. (3) to deploy a prototype PCARE system for image sharing in diverse types of facilities located in rural and urban communities to demonstrate the feasibility and measure the acceptance of patients, providers and other stakeholders. The concept could be easily expanded to additional components of the electronic health record. PUBLIC HEALTH RELEVANCE: Medical imaging is a major health care cost and current strategies to share image data between providers are inadequate and cause higher costs and negative health consequences to patients. We will develop and test a novel approach for sharing medical image data using a Personal Health Record (PHR) approach in rural and urban southeastern U.S., a diverse region with established unmet health care needs.

描述（由申请人提供）：医学成像是医疗保健的重要且昂贵的组成部分，每年花费 1000 亿美元或每人 350 美元。卫生信息技术（HIT）被提议作为通过更高效和协调的服务来降低成本和改善健康的手段。健康需求未得到满足的社区将获得最大收益；然而，这些社区面临着独特的 HIT 挑战。我们提出了一个在美国东南部农村和城市共享临床影像数据的示范项目。 个人健康记录（PHR）方法有望成为共享医疗信息的有效框架；然而，成像带来了独特的挑战。现有的方法包括一个集中存储库，如果扩展到医学成像，将需要大量的档案和网络基础设施。目前大多数社区，特别是农村和服务欠缺的社区，并不存在这些资源，从而造成后勤和财政障碍。 我们提出了一种新方法，将其命名为“个人控制访问密钥注册表”或 PCARE。 PCARE 解决了将大量成像数据从成像提供商转移到集中存档的基本问题。在 PCARE 范式中，成像数据作为主要存档保留在执行成像提供者处，直到授权的医疗保健提供者需要为止。 PCARE 取代了 PHR 档案，成为安全加密电子“密钥”的中央存储库。这些电子“钥匙”由患者或授权代表直接控制。患者可以授予和撤销提供者对其数据的访问权限，无论患者、图像或提供者的物理位置如何。可以选择性且及时的方式将成像数据从执行设施直接传输至患者选择的任何提供者。这项创新充分利用了 PHR 范例的患者控制性质，并克服了集中式健康记录方法在成像方面的许多缺陷。 广泛的长期目标是通过改善医学成像数据的共享来改善医疗保健。有效的共享可以改善诊断、减少不必要的测试并控制成本。具体目标是：(1) 分析美国东南部农村和城市的患者、提供者和医疗机构的医疗图像共享的需求、能力和障碍，作为服务不足社区的国家模式。 (2) 使用 PCARE 开发用于医疗图像共享的患者控制平台，旨在与参与提供者的电子健康记录无缝集成。 (3) 在农村和城市社区的不同类型的设施中部署用于图像共享的原型 PCARE 系统，以论证可行性并衡量患者、提供者和其他利益相关者的接受程度。这个概念可以很容易地扩展到电子健康记录的其他组成部分。 公共卫生相关性：医学成像是一项主要的医疗保健成本，目前在提供者之间共享图像数据的策略不充分，会导致更高的成本和对患者的负面健康后果。我们将在美国东南部农村和城市（一个医疗保健需求未得到满足的多元化地区）开发和测试一种使用个人健康记录 (PHR) 方法共享医学图像数据的新方法。