How do you define regional? The geography of health information exchange.

项目总结/摘要 不同医疗机构之间的患者信息交换可以帮助 改善病人护理的协调、成本和质量。改善提供者与患者的接触 信息是联邦和州卫生保健政策一个重要方面。的共同特征 美国各地的卫生信息交换工作（HIEs）是在一个特定的 地理区域（例如城市、地区或州）。我们并不知道缺氧缺血性脑病的程度 覆盖全国，这意味着个人可能会被包括在一个以上的努力， 提供商可能没有本地交易所可以参与。这就提出了以下问题：1）如何 定义HIE交换服务领域和2）HIE实际交换的含义是什么 服务领域的病人健康，实践，政策和评估？该提案旨在建立 并澄清地理概念，这是HIE活动的基本组成部分， 探讨如何界定交换服务区的实际和政策影响， 三个目标。第一种是利用地理信息系统分析， 比较HIE本身定义的健康信息交流活动的程度， 成员组织的医疗保健市场。此外，通过地理信息系统，本提案旨在 合并多个与医疗保健相关的数据集，以创建新的措施来帮助评估HIE工作。 最后，通过定性地理信息系统技术，本项目建议采访 HIE、参与医疗保健组织和非参与医疗保健组织 关于地理和合作在HIE功能有效性方面的作用， 对患者健康的影响。这项建议涉及AHRQ的健康信息研究领域 支持以病人为中心的护理的技术，在护理过渡期间的护理协调 环境，并使用电子交换健康信息，以提高护理质量。

Project Summary/Abstract The exchange of patient information between different healthcare organizations and can help improve the coordination, cost and quality of patient care. Improving provider access to patient information is a critical aspect of both federal and state healthcare policy. A common feature of health information exchange efforts (HIEs) across the U.S. is operation within a specific geographical area (e.g. a city, region or state). We don't actually know the extent of HIE coverage across the country, meaning individuals may be included in more than one effort or providers may have no local exchange in which to participate. This raises the questions of 1) how to define HIE exchange service areas and 2) what are implications of HIEs' actual exchange service areas on patient health, practice, policy and evaluation? This proposal seeks to establish and clarify the concept of geography that is a fundamental component of HIE activity and explore the practical and policy implications of how exchange service areas are defined through three aims. The first is to use geographic information systems (GIS) analyses to determine and compare the extent of health information exchange activity as defined by HIE themselves and by the healthcare markets of member organizations. In addition, through GIS this proposal aims to merge multiple healthcare related datasets to create new measures to help evaluate HIE efforts. Lastly, through qualitative GIS techniques, this project proposes to interview representatives of HIEs, participating healthcare organizations and non-participating healthcare organizations about the role of geography and cooperation in the effectiveness of HIE functionality and the effect on patient health. This proposal addresses the AHRQ research area of health information technology to support patient-centered care, the coordination of care across transitions in care settings, and the use of electronic exchange of health information to improve quality of care.